Cross-modal and intramodal transfer as predictors of mental development in full-term and preterm infants.

25 full-term (FT) and 33 preterm (PT) infants who had participated in studies of cross-modal (CM) and intramodal (IM) transfer at 12 mo of age were seen at older ages to assess the predictive validity of these early measures for later cognition. FT Ss were administered the Bayley Scales of Infant Development at 24 mo of age; PT Ss were administered these scales at 12 and 24 mo of age, the Stanford-Binet Intelligence Scale (Form L-M) at 34 and 40 mo of age, and the Wechsler Intelligence Scale for Children—Revised and the Developmental Test of Visual-Motor Integration at 6 yrs of age. For FT Ss, both 12-mo measures were significantly related to 24-mo Bayley Mental Development Index (MDI) scores; for PT Ss, both 12-mo measures were related not only to 24-mo Bayley MDI but to each subsequent measure of cognitive outcome through 6 yrs. 12-mo IM scores were highly correlated with the 6-yr assessment of visual–motor integration. A measure of object permanence obtained at 12 mo was also related to cognitive outcome, but not so consistently as were the other 2 12-mo measures. Although parental education was a significant predictor beginning at 24 mo, multiple regression analyses indicated that the CM and the IM measures substantially increased the percentage of variance in outcome that could be accounted for by parental education alone. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determination of thermoregulatory state in full-term infants

A series of nine sets of axillary and tympanic (core) temperature readings were collected from each of 45 full-term infants during the first 4 hours after birth. The pattern of readings and the relationship between axillary and tympanic temperature readings were examined in each infant to determine whether the type of thermal state could be detected and categorized. The findings support the supposition that different thermal states are present and can be determined by the relationship between tympanic and axillary temperature readings. The ability to predict tympanic temperature decrease could not be predicted through examination of axillary-tympanic temperature patterns.     

Apnea following spinal anaesthesia in two former pre-term infants

Telomerase activity is associated with the proliferative activity of cells. In the endometrium, telomerase activity is higher in the proliferative phase than in the secretory phase of the menstrual cycle, suggesting that telomerase activity may occur primarily in the glandular epithelial cells. To test this, a dissociated cell culture of the endometrium was performed, and the telomerase activity in each cell fraction was analysed. Telomerase activity was found in all 10 endometrial tissues of the proliferative phase of the menstrual cycle. Both the fragments of epithelial glands and single cells, which were prepared by enzymatic dissociation, showed telomerase activity. In the 7 day cell culture, it was found in nine out of 10 epithelial cell enriched fractions, but in none of the stromal cell enriched fractions. Flow cytometric analysis showed that the epithelial enriched fraction was contaminated with a predominant number of stromal cells, while the stromal cell enriched fraction was comprised mostly of stromal cells with apparent proliferative activity. Our results suggest that telomerase activity of the endometrium occurs primarily in the epithelial cells in the endometrium and that the stromal cells do not express telomerase activity regardless of their potent proliferative activity.     

Bacille Calmette Guérin vaccination in pre-term infants

OBJECTIVE: To evaluate the efficacy of bacillus Calmette Guerin (BCG) vaccine in pre-term infants. DESIGN: BCG vaccine was given to three groups of neonates: 1) 36 pre-terms born at different gestational ages (GA) vaccinated at birth, 2) 16 pre-terms vaccinated at 40 weeks post conceptional age, and 3) 20 full-terms vaccinated at birth. All of the infants were tested by purified protein derivative (PPD) 2-4 months post vaccination. RESULT: The mean sizes of BCG scarring and PPD tuberculin induration were largest in full-term and smallest in pre-term infants vaccinated at birth. The pre-term infants of lower GA (27-33 weeks) had non-significantly smaller BCG scar and PPD induration than the pre-terms of higher GA (34-36 weeks). The results of logistic regression analyses revealed that female infants were more likely to have a BCG scar, and both birth weight and female sex were significantly associated with a reactive PPD induration. CONCLUSION: This study indicates that male pre-term infants of lower GA (<33 weeks) are less likely to develop BCG scar and a reactive PPD tuberculin test after BCG vaccination. These findings do not support routine BCG vaccination at birth of pre-term neonates of GA <33 weeks. Studies including larger groups of infants are needed to confirm these findings.     

The intrauterine turnover of thiamin in preterm and full-term infants

A quality assurance program of the Chagas' disease laboratory network of Argentina has been conducted by the National Reference Center since 1988, with the aim of assessing the reliability of serologic test results. Chagas' disease is endemic in Argentina, but the prevalence of seropositivity for Trypanosoma cruzi among 18- to 20-year-old men decreased from 5.8% in 1981 to 1.8% in 1994. About 600 laboratories form the Chagas' disease laboratory network, with main central laboratories in each of the 24 provinces in Argentina. The quality assurance program promotes regular use of good laboratory practice and internal and external quality control to improve performance of the participants; it also provides technical assistance and guidelines. Eventual corrective measures are discussed in workshops. Results of the first external evaluation by proficiency testing of serum panels and confirmation of results for 58 of the main laboratories reveal that from 1988 to 1994 the rate of agreement has increased.     

Placental transfer of enrofloxacin and ciprofloxacin in rabbits

Placental transfer of enrofloxacin and ciprofloxacin was evaluated, using a rabbit in situ perfusion model. A two-step infusion program was carried out to obtain steady-state maternal plasma concentrations of these drugs. For each compound, the placenta in 5 rabbits was perfused for 200 minutes with Earle's enriched bicarbonate buffer at flow rate of 1.5 ml/min. To assess reliability of the model, most of the determinants of placental transfer (maternal and fetal pH, gas balance, heart status, rectal temperature, and protein binding) were controlled. In addition, the infusion program included administration of antipyrine, a commonly used indicator of placental exchange. Drug concentrations were measured in maternal plasma and perfusate by use of a high-performance liquid chromatographic assay. Plasma protein-binding estimation indicated no differences between the drugs. Placental clearance of the drugs was significantly (P < 0.01) different (0.88 +/- 0.13 ml/min for enrofloxacin and 0.06 +/- 0.02 ml/min for ciprofloxacin). These values accounted for 81 and 5%, respectively, of the placental clearance found for antipyrine. These results indicate that caution must be taken when enrofloxacin is to be used during pregnancy, and suggest the need to extend this type of experiment to species that can be exposed to these drugs used for therapeutic or prophylactic purposes.     

Reactivity and developmental competence in preterm and full-term infants.

Evaluated physiological and behavioral reactivity to a novel stimulus in 24 preterm and 24 full-term infants at 8 mo and examined its association with developmental competence. Infants who reacted to the stimulus with increased vagal tone more often engaged in focused examination and exhibited greater range in exploratory play than those whose vagal tone decreased in response to the stimulus. Some differences in developmental performance were detected based on term status. Preterm perinatal risk factors were inversely associated with exploratory examination and range. Results are discussed in terms of a challenge model for assessing behavioral and physiological functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Visual function in full-term infants with hypoxic-ischaemic encephalopathy

Malignant melanoma with primary onset in the nasal cavity and paranasal sinuses remains a scarcely encountered malignancy and we report 12 cases of our own experience from 1991. These mucosal melanomas occur mainly in the elderly and present most commonly as a one sided airway obstructive syndrome with often bleeding in the nasal cavity. No sex or race ratio is found. Histological examination of the surgical specimen has been made easier since the use of immunohistochemical studies. The original site of onset is commonly located at the inferior part of the nasal cavity but in many cases, it is noted several sites of tumor localization. Despite well conducted treatment the prognosis remains quite deceiving and significantly poor. In our study, the 4-year actuarial survival was 26%. The 5-year survival rate ranges in the literature from 10% to 40%. Short and long term follow-up show an important rate of recurrence (local and lymph node metastases as well as distant metastases). The insidious evolution of the malignancy usually happens during the first year. Computed tomography and MRI are essential in the evaluation of tumor extension. The treatment is based on the combination of surgery and radiotherapy: Surgery is practised first and must ensure sufficient excision of the tumor without minimal functional or aesthetic damage in this complex region. This surgery is based on surgical approaches to the midface known as Lateral rhinotomy and midfacial degloving. When there is cervical lymph node involvement at the time of diagnosis it is suitable to treat it, even in case of recurrence. Complementary high dose radiation is required to treat tumors which could not undergo surgery and also as adjuvant therapy after removal of the mass.     

Analysis of renal water excretion in full-term newborn infants

The clinicopathologic characteristics of two patients with Gorham's disease and bilateral recidivant pleural effusions are reported. The first case corresponded to a nine year-old girl with osteolysis in her right clavicle and ribs. The second case was a 55 year-old male with osteolytic lesions in ribs, cranium, pelvis and femurs; a thymic cyst was also documented. In both patients, biopsies were performed from ribs, which showed proliferating, benign, thin walled small vessels that extensively replaced the intertrabecular spaces. Thoracocentesis, instillation of talcum and radiation therapy were used in the former patient and no recidivant pleural effusions have developed after one year. The second patient was not treated with radiation therapy, persisted with pleural effusions and finally died two years after the diagnosis. Because Gorham's disease is rare, it was not immediately suspected in the cases described here. Its association with pleural effusion is even rarer and has been mentioned only occasionally in the literature. The utility of radiation therapy in Gorham's disease is commented.     

Auditory–visual responsiveness in full-term and preterm infants.

Compared older preterm and full-term infants in their response to objects in a dynamic multimodal context. In Study I, 67 12-wk-old full-term infants and 29 preterm infants (mean age 90 days) served as Ss. After familiarization with a silent moving object, full-term Ss recognized the object when it was stationary. When sound accompanied the moving object during familiarization, full-term Ss showed increased attention to the object but no subsequent recognition of that object. Neither high- nor low-risk preterms, at a comparable conceptional age, recognized the objects under any condition, but the low-risk preterms did show greater attention to the moving objects with sound. In Study II, 43 preterm Ss were tested approximately 6 mo after their estimated term date. The performance of the low-risk preterms was the same as that of full-terms; that is, through differential responding, they demonstrated association of an object and sound. In contrast, the high-risk preterms showed no differential looking. Thus both low- and high-risk preterms showed less differential responding than did normal full-terms at 3 mo, but at 6 mo only the high-risk preterms were different from the full-terms. Results suggest that the high-risk preterms are at a disadvantage for learning about the dynamic and multimodal aspects of their environment. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Placental transfer and neonatal effects of propofol in caesarean section

Rheumatoid arthritis (RA) patients are at higher risks of bacterial infection than healthy subjects. Polymorphonuclear leukocytes (PMN) are the first line of nonspecific cellular defence against these infections. We tested the hypothesis that abnormal directed migration of PMN may be one reason for the increased infection rate of RA patients. PMN migration was investigated in 68 peripheral blood samples of 15 RA patients compared with 64 samples of healthy controls in a novel whole blood in vitro membrane filter assay. The migration of PMNs from RA patients and controls was stimulated using the bacterial chemoattractant N-formyl-methionyl-leucyl-phenylalanine (fMLP). Unstimulated PMN migration of RA patients was increased compared with healthy controls as measured by the following parameters: (a) absolute number of migrant PMNs (1954+/-87 vs. 1238 +/-58 PMN/mm2), (b) percentage of PMNs migrated into the filter (total migration index, TMI) (28.6+/-0.9 vs. 24.0+/-0.8%), (c) the distance half the migrating PMNs had covered (distribution characteristic, DC) (22.6+/-1.1 vs. 16.1+/-0.6 mm) and (d) the product of TMI and DC (neutrophil migratory activity, NMA) (669.0+/-45.0 vs. 389.0+/-18.9). fMLP stimulated PMNs of RA patients showed defective migration compared to unstimulated samples as shown by (a) a reduced number of migrant PMNs (1799+/-93 PMN/mm2), (b) lower TMI (26.1+/-0.9%), (c) unremarkable altered distribution characteristic (22.9+/-0.8 mm) and (d) significant reduced migratory activity (600.0+/-30.0). Our data suggest that the high incidence of infections in RA patients may partly be caused by defective migratory activity of PMNs to bacterial chemoattractants as demonstrated by fMLP.     

Placental transfer and fetal uptake of 3H-digoxin in humans

Placental transmission and fetal distribution of 3H-digoxin were studied in seven pregnant women undergoing legal termination of pregnancy during the first half of gestation. The radioactivity in fetal and maternal plasma and in fetal tissues was estimated using the oxidation method, and the integrity of the labelled drug by thin layer chromatography. The 3H-digoxin activity was clearly demonstrated in the umbilical cord blood five minutes after injection of the drug into the maternal blood, and the fetal plasma concentrations of 3H-digoxin approximated to the maternal value 30 minutes after drug administration. The distribution of 3H-digoxin in the fetal tissues was relatively even, with the highest 3H concentrations found in the heart and placenta, the lowest in the brain. The results suggest that the capacity of human fetal heart to bind digoxin during the first half of gestation is limited.     

Outcome of neonatal stroke in full-term infants without significant birth asphyxia

Ehlers-Danlos syndrome (EDS) is a heterogeneous group of connective tissue disorders. Recently mutations have been found in the genes for type V collagen in a small number of people with the most common forms of EDS, types I and II. Here we characterise a COL5A2 mutation in an EDS II family. Cultured dermal fibroblasts obtained from an affected subject synthesised abnormal type V collagen. Haplotype analysis excluded COL5A1 but was concordant with COL5A2 as the disease locus. The entire open reading frame of the COL5A2 cDNA was directly sequenced and a single base mutation detected. It substituted a glycine residue within the triple helical domain (G934R) of alpha2(V) collagen, typical of the dominant negative changes in other collagens, which cause various other inherited connective tissue disorders. All three affected family members possessed the single base change, which was absent in 50 normal chromosomes.     

Taste-mediated calming in premature, preterm, and full-term human infants.

Calming by sucrose and glucose was evaluated in premature, preterm, and term infants. In Experiment 1, 9 preterm and 9 term infants each received 0.5 ml (0.1 ml/min) sucrose (12% w/v) solution; 9 age-matched preterm and 9 other term infants received water. In Experiment 2, 9 premature and 9 term infants received a 10% glucose solution. Sucrose reduced crying in preterm and term infants by 91% and 93%, respectively. Glucose reduced crying in premature and term infants by 86% and 81%, respectively. Water was ineffective in both preterm and term infants. Thus, reduced crying cannot be attributed to fluid ingestion per se. Calm induced by either sugar persisted longest in term infants after conclusion of sugar delivery. Accordingly, sensory systems that detect sweet taste and central mechanisms that transduce this change to calm crying infants are functional before normal term and may be engaged during the initial suckling bouts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The organization of leg movements in preterm and full-term infants after term age

In a sample of 13 full-term and 10 preterm infants, the development of kicking movements was studied at 6, 12, and 18 weeks (corrected) age. In healthy full-term infants some characteristics are strikingly stable, such as the duration of the flexion and extension phase and the within-joint organization. These parameters did not differ in preterm compared to full-term infants. For other features, however, developmental changes and differences were observed. Full-term infants tended to decrease their kick frequencies slightly with age. In preterm infants much higher initial kick rates were found, followed by a steep decrease, which resulted in kick frequencies comparable to the full-term levels after the (corrected) age of 12 weeks. There is a tight coupling between the movements in the different joints of the leg in full-term newborns. Preterm infants, in contrast, initially show much lower cross-correlations between hip and ankle and between knee and ankle. This is particularly the case for those preterm infants who were born before 32 weeks gestation. Again, the differences resolved after the age of 12 weeks, which might be related to a transformation in neural functions reported previously around this age. The initial differences in the characteristics of kicking appeared to be more readily explainable by differences in neurological condition than by contrasts in leg volume or postural control.     

Cardiac and behavioral responsivity to tactile stimulation in premature and full-term infants.

Attempted to determine whether psychophysiological differences exist between prematurely born and full-term infants in their responsivity to tactile stimulation and in their ability to discriminate among different intensities of such stimulation. The performance of 20 full-term neonates in active sleep was compared with that of 20 premature infants of comparable conceptional age (average, 38.5 wks). Whereas the full-term Ss showed both behavioral responsiveness and heart rate acceleration to the stronger levels of stimulation, the premature Ss showed weaker behavioral responses and no significant cardiac response. Even on those trials where the premature infants did show strong behavioral response, their cardiac response was smaller than that of the full-term infants. A significant sex difference for premature Ss indicated that the lower behavioral responsiveness was due mainly to males. Issues raised were whether the lack of cardiac responsivity in the premature infant is secondary to his/her heightened level of autonomic arousal whether it reflects a lack of integration between motor and autonomic systems. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Placental pathology and antiphospholipid antibodies: a descriptive study

We described placental pathology in antiphospholipid antibody (APL) syndrome, APL and no history of recurrent pregnancy loss, and in treated and untreated pregnancies of APL syndrome. Thirty-nine pregnancies of 28 patients were studied: 23 placentas delivered from 23 women with APL (13 with APL syndrome and 10 with serological APL); 8 untreated miscarriages before APL diagnosis from 6 of the 13 patients with APL syndrome and 1 of 10 with serological APL; and 8 miscarriages by 5 additional women before APL syndrome diagnosis. Histopathology was reviewed by a pathologist blinded except to gestational age. Contingency tables and analysis of variance (ANOVA) considered p < 0.05 significant. Comparing the placentas delivered at > 18 weeks' gestation, excessive perivillous coagulation, avascular terminal villi, and chronic villitis/uteroplacental vasculitis tended to be more common in treated APL syndrome than serological APL cases (p = 0.07). Of the 16 miscarriages before diagnosis of APL, 11 were lost at < 18 weeks' gestation. None had pathology typical of APL, but 4 of 11 (36%) had chronic intervillositis. Five of 16 miscarriages before the diagnosis of APL were miscarried between 18-22 weeks. Three of 5 (60%) miscarried after 18 weeks had multifocal uteroplacental thromboses, compared to 6 of 13 (46%) treated pregnancies with APL syndrome and 0 of 10 cases with serological APL.     

Prognosis after perinatal asphyxia in full-term infants. A literature review

Reviewing the literature published during the last 30 years we found comparable systematic studies of outcome for 1042 term infants born alive after likely intrapartum hypoxia-ischaemia. Fifty-two percent had no sequelae, 8% had developmental delay without associated handicaps, 4% had a single handicap, 11% were multihandicapped and 14% were dead as a consequence of the intrapartum hypoxia-ischaemia. The frequency of single handicaps exceeded the frequency found among the controls and in population studies. The frequency of children with developmental delay did not differ from that found among the controls. Outcome is closely related to the severity of hypoxic-ischaemic encephalopathy in the newborn.