Predictors of depressive symptom trajectories in mothers of preterm or low birth weight infants.

Predictors of maternal depression trajectories were examined longitudinally in families with an infant born preterm or at a low birth weight. A total of 181 mother–infant dyads enrolled in the study before the infant’s neonatal intensive care unit (NICU) discharge. Maternal depressive symptoms were assessed at 5 timepoints, and contextual variables and infant risks were assessed at NICU discharge. Hierarchical linear models revealed that mothers who experienced more risk factors reported more depressive symptoms just before their infant’s NICU discharge and showed less decline in depressive symptoms in the months immediately following the child’s birth. Although cumulative risks predicted depression trajectories, this effect appeared driven by maternal and family sociodemographic risks rather than infant risks. Addition of family support as a covariate in the multilevel models with a subsample of families revealed that social support and depression covaried across time. However, most of the findings regarding the association between risk and depression remained consistent, whereas the effects of maternal race and multiple birth were slightly attenuated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment patterns of infants separated at birth.

The effect of minimal maternal–infant contact and prolonged separation following birth was examined in 29 premature and seriously ill full-term neonates to assess their attachment relationships to their caregivers at approximately 12 mo postgestational age. Ss were classified into the M. D. Ainsworth et al (1978) categories of secure, anxious avoidant, and anxious resistant. Secure vs insecure Ss could not be differentiated on Bayley developmental scores, birth weight, gestational age, days of neonatal intensive care unit hospitalization, or parental visiting patterns. Data suggest that attachment patterns are influenced by maternal–Ss interaction over time and provide evidence for the resiliency of Ss in their formation of attachment patterns. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increased incidence of neoplasia in females with acromegaly

Gestational diabetes mellitus (GDM) constitutes a risk factor for the development of non insulin-dependent diabetes mellitus (NIDDM). The search for parameters to provide discrimination between a high risk and a low risk for future development of NIDDM is today the aim of many investigations. The absence or presence of several factors such as glycemia during pregnancy and post partum, the need for insulin treatment, disorders of the pancreatic insulin secretion, the number of pregnancies, maternal obesity, the early diagnosis of GDM, the family history of diabetes mellitus, the race and immune disorders give rise to a very high relative risk (RR) of developing NIDDM. To know the degree of risk will allow a future appropriate clinical intervention to reduce the incidence of NIDDM and its economic cost.     

The in vivo effect of recombinant human granulocyte-colony stimulating factor in neutropenic neonates with sepsis

The effects of recombinant granulocyte-colony stimulating factor (rhG-CSF) in neonatal neutropenia with presumed sepsis, which has a poor prognosis, were investigated. The study involved 14 neonates with presumed sepsis and neutropenia. Findings were compared with those from 24 historical controls. rhG-CSF (5 micrograms/ kg/day i.v. for 5 days) was administered immediately following diagnosis. Complete blood counts were obtained before and 24, 48, 72, 96 and 120 h after initiation of treatment. Neutrophil storage pool (NSP) was assessed (in 4 patients) before and after treatment. Statistical analysis was performed using one way analysis of variance. Treatment led to an increase in absolute neutrophil count (ANC) levels in 13/14 patients. At the end of treatment, the mean ANC was higher than that of controls (P = 0.007). There was a marked increase in the NSP of between 32% and 65% (P = 0.005). There were two clinical failures, one of whom was considered to have died from his underlying condition. There were no reports of clinical or haematological toxicity during treatment or follow up.     

DiGeorge anomaly with renal agenesis in infants of mothers with diabetes

We report on 2 infants with the DiGeorge anomaly born to diabetic mothers treated with insulin. Both infants had unilateral renal agenesis. One of the mothers has manifestations suggestive of velo-cardio-facial syndrome (VCFS). Cytogenetic studies on both patients and the mother with apparent VCFS were normal. Molecular studies utilizing probes from the DiGeorge critical region did not demonstrate a 22q11 microdeletion in either patient or the mother with apparent VCFS. We conclude that maternal diabetes is a pathogenetic factor in the DiGeorge anomaly, and infants of diabetic mothers who have this anomaly should also be screened for renal agenesis.     

Vitamin A levels at birth of high risk preterm infants

Inclusion body myositis is an increasingly recognised form of inflammatory myopathy with characteristic clinical and histopathological features which has seldom been reported in the United Kingdom. This paper presents the clinicopathological features of a series of patients diagnosed in Nottingham from 1986 to 1990. During this period, 1319 muscle biopsy samples were processed by this laboratory and rimmed vacuoles were seen in 17 patients. Eleven patients had definite or probable inclusion body myositis according to published criteria. The mean age of the group was 69.4 years with a male to female ratio of 8:3. Typical clinical features were a slowly progressive painless, proximal lower limb weakness, with muscle wasting and early loss of reflexes. The median duration of illness from first symptom to presentation was five years (range 2-18 years). Falls were a prominent symptom in six patients and distal weakness occurred in nine patients. Creatine kinase was increased in 10 patients but only one had a level > 1000 IU/l; the erythrocyte sedimentation rate was normal in five patients. Treatment with steroids or cytotoxic drugs, or both, did not prevent disease progression. It is confirmed that inclusion body myositis is a distinct cause of inflammatory myopathy which is probably underdiagnosed in the United Kingdom. Clinically, it should be suspected in older patients presenting with muscle weakness of insidious onset. Pathologically, a careful search should be made for rimmed vacuoles and inflammation; ultrastructurally, the presence of inclusions will confirm the diagnosis.     

Increased incidence of cancer in infants in the U.S.: 1980-1990

BACKGROUND: During the decade between 1980-1990, the rate of cancer in children in the U.S. increased. It is unknown whether cancer in infancy, which is biologically and clinically different from cancer in older children, also increased. METHODS: To evaluate changes in cancer incidence in infants in the U.S. age < 1 year, data from the Surveillance, Epidemiology, and End Results (SEER) program and the U.S. Bureau of the Census were used to construct age specific, population-based cancer incidence rates. RESULTS: Overall, the annual cancer rate in infants increased from 189 cases per million infants between 1979-1981 to 220 between 1989-1991. At both timepoints, female infants had higher cancer rates than male infants. Although the rates for female infants remained stable at 223 between 1979-1981 versus 236 between 1989-1991, rates for male infants increased from 158 to 205 during the same timepoints. Male infants had increased rates of central nervous system (CNS) tumors (P < 0.05), neuroblastoma, and retinoblastoma; female infants had increased rates of teratomas (P < 0.01) and hepatoblastomas. Between 1979-1981, the three most common types of cancer in infants were neuroblastoma, leukemia, and renal tumors (27%, 15%, and 14%, respectively), and were neuroblastoma, CNS tumors, and leukemia between 1989-1991 (27%, 15%, and 13%, respectively). CONCLUSIONS: This study shows that the rate of certain types of cancer in infants in the U.S. is increasing. Studies of both genetic and environmental factors are needed to explain these increased rates and the changing distribution of cancer in the first year of life.     

Seasonal change in the incidence of preeclampsia in Zimbabwe

BACKGROUND: The aim of our study was to evaluate the number of women with hypertensive complications during pregnancy in a southern province in Zimbabwe and to examine the annual change in the incidence of preeclampsia. METHODS: In three different hospitals the preeclamptic women who were treated between January 1992 and August 1995 were counted. This data was compared with the amount of rainfall obtained from the local meteorological stations. RESULTS: A distinctive change in the incidence of preeclampsia during the year could be observed. These changes go along with the seasonal variation in precipitation: at the end of the dry season and in the first months of the rainy season there is an increase in the incidence. CONCLUSIONS: The relationship between climate and occurrence of preeclampsia raises new questions in the pathophysiology of preeclampsia. Possible explanations could be the impact of humidity and temperature on vessels or the production of vasoactive substances. Dry and rainy seasons influence the agricultural yields and therefore the nutritional status could also play a role in the pathophysiology.     

Absorption of pteroylpolyglutamates in mothers of infants with neural tube defects

The ability to hydrolyse and absorb pteroylpolyglutamates (PteGlun) included in a standard meal in mothers who had given birth to an infant with a neural tube defect was tested by comparing them with mothers who had not had any infants with this defect. When compared with control mothers working in the research unit in which the study was performed, case mothers had significantly lower baseline serum and erythrocyte folate levels, and smaller increases in serum folate following the meal containing PteGlun. However, all estimates of folate were similar when case mothers were compared with a group of mothers who were friends of the case mothers. The results show that the higher the baseline levels of serum and erythrocyte folate the greater the increase in serum folate after the test meal. Fitting a model for the serum folate response curve resulted in coefficients which differed significantly between case mothers and all control mothers. We conclude that intestinal hydrolysis of PteGlun taken orally is not impaired in mothers who have had infants with neural tube defects when compared with control mothers with similar baseline folate levels, although the curves describing the response to the meal for the two groups do differ significantly. Further investigation is required to determine the mechanism underlying this difference.     

15N liver function test in underweight infants, hypotrophic at birth

Fifty-two infants were enrolled in the study: 23 hypotrophically born infants (birth weight < 5th percentile according to Kyank) with present body weights < 3rd percentile according to Prader (group 1), 15 patients suffering from severe liver diseases (group 2), 14 patients without liver diseases (group 3). Usual serum parameters were estimated. Additionally, the hepatic detoxification capacities were measured using the non-invasive, non-radioactive [15N]methacetin urine test. 17 of the 23 infants of group 1 showed 15N elimination rates as low as in severe liver-diseased patients (group 2) whereas their serum parameters were in the normal range, as were those of group 3. The question remains whether intra-uterine malnutrition or postnatal effects, e.g., environmental conditions, caused the functional liver damage.     

Increased incidence of depressive symptoms in men with erectile dysfunction

OBJECTIVES: To investigate the hypothesis that men with erectile dysfunction (ED) have a higher incidence of depressive symptoms compared with age-matched control subjects. We also hypothesized that depressive symptoms impact on the level of libido and on the success of treatment of ED. METHODS: One hundred twenty men with ED or benign prostatic hyperplasia (BPH) were divided into three groups. Group 1 had ED only, group 2 had BPH only, and group 3 had both ED and BPH. Patients were screened for depressive symptoms using the Primary Care Evaluation of Mental Disorders and the Beck Depression Inventory. They were also surveyed for comorbidity, marital status, severity of ED, level of libido, prior ED treatment choice (if any), success of treatment, and others. RESULTS: One hundred patients completed the questionnaires. Depressive symptoms were reported by 26 (54%) of 48 men with ED alone, 10 (56%) of 18 men with ED and BPH, and 7 (21 %) of 34 men with BPH alone. Patients with ED were 2.6 times more likely to report depressive symptoms than men with BPH alone (P < 0.005). Patients with depressive symptoms reported lower libido than other patients (P < 0.0001). Severity of comorbidities did not differ among the three groups. A total of 33 patients with ED had prior treatment for ED using penile injections or vacuum devices. All 15 (100%) patients with ED only continued treatment and were satisfied with its outcome, whereas only 7 (38.9%) of 18 patients with ED and depressive symptoms continued treatment (P < 0.00021). CONCLUSIONS: ED is associated with high incidence of depressive symptoms, regardless of age, marital status, or comorbidities. Patients with ED have a decreased libido compared with control subjects. In addition, patients with depressive symptoms have a lower libido than patients without depressive symptoms. Patients with ED and depressive symptoms are more likely to discontinue treatment for ED than other patients with ED. These data emphasize the importance of a multidisciplinary approach to the treatment of erectile dysfunction.     

Interactions of African American infants and their mothers: relations with development at 1 year of age

The relationships between aspects of mother-infant interaction and both communication and cognitive skills at 1 year of age were examined in 92 African American dyads, of whom 64 (70%) fell below the poverty line. Ratings of warmth, sensitivity, responsiveness, encouragement of initiative, stimulation, and elaborativeness during a semistructured play interaction were correlated with measures of global cognition, expressive and receptive communication, and communication use. The overall quality of the home environment and maternal ratings of stimulation and elaborativeness were the most consistent correlates of infant communication measures. Relationships were stronger in middle-income than lower-income dyads. These results support the linkage of didactic and functional aspects of maternal behavior to cognitive and communication skills at 1 year of age for African American infants.     

Maternal directiveness and infant compliance at one year of age: a comparison between mothers and their developmentally-delayed infants and mothers and their nondelayed infants

Maternal directiveness and infant compliance at one year of age were observed in social interactions between mothers and their handicapped and nonhandicapped infants. Eleven nondelayed, typically developing infants, and nine developmentally delayed infants, matched for chronological age, were observed in a free play situation with their mothers. Mothers of the delayed infants attempted to direct their children's play significantly more than those with nondelayed infants, and they engaged more frequently in social play involving physical contact with their infants. Nondelayed infants complied with their mothers' directives more than the developmentally delayed infants. Further study of infant capabilities and maternal affect and behaviors with this age group is suggested.     

Facial expressivity in infants of depressed mothers.

Examined facial expressions in 84 3-mo-old infants of mothers classified as depressed, nondepressed, or low scoring on the Beck Depression Inventory. Mother–infant dyads were videotaped during a 3-min face-to-face interaction, and the videotapes were coded by using the AFFEX facial expression coding system. Infants of both depressed and low-scoring mothers showed significantly more sadness and anger expressions and fewer interest expressions than infants of nondepressed mothers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effective pulmonary capillary blood flow in infants with birth asphyxia

Effective pulmonary capillary blood flow was measured on the first day of life in twenty term infants with birth asphyxia and twenty-five normal term infants. The infants studied showed no clinical or laboratory evidence of respiratory distress. The mean effective pulmonary capillary blood flow of 121 ml/kg/min in the birth asphyxia group was significantly lower than the mean of 162 ml/kg/min in the normal group. The possible relationship of birth asphyxia and pulmonary hypoperfusion in the aetiology of the idiopathic respiratory distress syndrome is discussed.     

High anti-IgE levels at birth are associated with a reduced allergy prevalence in infants at risk: a prospective study

Development of atopic disease was prospectively studied in 148 children from birth to the age of 18 months and related to serum levels of IgG anti-IgE antibody. Children with a dual heredity of allergy, but remaining healthy, had significantly higher IgG anti-IgE levels at birth than children with a similar predisposition to allergy, who became allergic. Children with increased allergy risk, defined by elevated IgE levels at birth (> = 0.53 kU/l) and with probable allergy symptoms had also significantly higher IgG anti-IgE levels at birth than children of the same risk group, developing definite allergy. Independent of allergy risk, there was a significantly lower prevalence of atopic disease in children with cord serum levels of IgG anti-IgE above 350 AU/l than in children with lower levels. Additionally, we showed that the allergy predictive capacity of IgE levels in cord serum was slightly improved in specificity, sensitivity and efficiency by including not only the family history of allergy, but also cord serum levels of IgG anti-IgE. Our results thus raise the possibility that high levels of IgG anti-IgE protect children of increased allergy risk from early development of atopic disease and reduce the severity of symptoms.     

Maternal risk factors in infants with very low birth weight

To determine whether maternal risk factors associated with the delivery of very low birth weight infants under 1501 g are different from those associated with low birth weight infants of 1501 to 2500 g, prenatal data on 12,247 deliveries were evaluated. The sample contained 302 very low birth weight infants. Maternal race, age, height, weight, gravidity, parity, past pregnancy performance, and pregnancy complications were analyzed. Factors related to very low birth weight but not to low birth weight infants were previous abortions, previous fetal deaths, and hypertensive vascular disease. Race, maternal height, and prepregnancy weight were not related to very low birth weight but were associated with an increase in low birth weight. There was no significant difference in the rate of very low birth weight or low birth weight by maternal age from 14 to 40 years. These results contradict the concept of a uniform set of predisposing factors for birth of all infants weighing 2500 g or less.     

Clostridium septicum sepsis and neutropenic enterocolitis in a patient treated with intensive chemotherapy for acute myeloid leukemia

A retinal dopaminergic deficiency underlies some visual changes in Parkinson's disease (PD), in particular those elicited by stimuli near the peak of the human and monkey spatial contrast sensitivity. The correspondence of retinal changes and VEP alterations is not perfect: they do not seem to rely on identical mechanisms. It seems that additional pathology beyond the retina affects visual responses, including VEPs. The relevance of "distal" primary VEP changes to higher cognitive visual abnormalities in PD is not established at present.