Prolonged exposure to a visual pattern may promote behavioral organization in preterm infants

The article reports a study documenting preterm infants' responses to visual patterns placed in their incubators in the neonatal intensive care unit (NICU) and the effects of long-term exposure to the patterns. In the first experiment, 20 preterm infants were exposed to a visual pattern in two conditions, stationary and rotating, during two successive exposure periods. Regardless of condition, the majority of infants looked longer at the visual display during the second exposure period and experienced decreased heart rates and quiet, alert states. In a second experiment, visual patterns placed in 9 preterm infants' incubators on transfer to the intermediate side of the NICU remained in the incubator until discharge. An additional 9 infants served as controls. Infants exposed to the visual patterns experienced fewer state changes and stronger visual skills than infants in incubators without visual displays. These findings, although tentative because of the relatively small sample sizes, suggest that visual patterns may promote behavioral organization and visual skills in preterm infants.     

Helicobacter pylori and gastroesophageal reflux disease: the bug may not be all bad

Peptic ulcer disease and gastric cancer of the antrum and body have been declining in the 20th century. In contrast, a new group of diseases are increasingly rapidly in Western countries: gastroesophageal reflux disease, Barrett's esophagus, and adenocarcinoma of the distal esophagus. Recent studies suggest this phenomenon may be related to the simultaneous fall in the prevalence of Helicobacter pylori (H. pylori) colonization, especially by the virulent cagA + strains. H. pylori infection with the cagA+ strain is potentially protective against the spectrum of gastroesophageal reflux disease because it lowers intragastric acidity as the result of a pangastritis, frequently with multifocal gastric atrophy and possibly increased intragastric ammonia production. Assuming that some types of H. pylori strains are protective, our entire approach to the worldwide elimination of this organism, sometimes indiscriminately, will need critical reevaluation.     

Effects of fetal corticosteroid treatments on postnatal surfactant function in preterm lambs

Effects of prenatal corticosteroid on the properties of surfactant have not previously been evaluated. A single ultrasound-guided fetal injection with 0.5 mg/kg betamethasone 48 h before delivery of preterm lambs at 134- to 135-days gestation improved oxygenation, lowered the ventilatory pressures required to maintain arterial PCO2 between 30 and 40 Torr and decreased the protein leak of albumin from the intravascular to the alveolar space. This dose of glucocorticoid did not alter surfactant-saturated phosphatidylcholine pool sizes in the airspaces of preterm lambs. However, the treatment changed the characteristics of the surfactant recovered from the ventilated preterm lambs. The in vitro conversion from heavy to light subtype surfactant decreased from 59% for the saline-treated lambs to 37% for the corticosteroid-treated lambs after 180 min of surface area cycling (P < 0.02). Surfactant from the corticosteroid-treated lambs also increased the dynamic compliance of preterm surfactant-deficient rabbits more than did surfactant from the saline-treated lambs (P < 0.05). Prenatal treatment of preterm lambs with betamethasone improved the functional characteristics of surfactant without significant effects on the alveolar surfactant pool sizes.     

Neonatal neutrophil activation is a function of labor length in preterm infants

To understand better the development of the neonatal immune system, we evaluated the role of labor length, gestational age, and mode of delivery on the expression of the neonatal neutrophil cell surface antigens CD11b, CD11c, CD15, CD33, and CD66b in premature newborns. Peripheral blood samples from 68 apparently healthy preterm infants were obtained within 12 h of birth and incubated with MAb to the CD antigens. Samples were lysed, fixed, and analyzed by flow cytometry. Multivariate analysis was used to study the simultaneous effect of the labor length and gestational age on the neonatal neutrophil cell surface antigen expression. A positive correlation was demonstrated between neutrophil antigen expression and labor length (p < 0.001-0.026) but not with the mode of delivery (p = 0.191-0.638). There was no significant correlation between expression of neutrophil antigens and gestational age at delivery (p = 0.057-0.866), except for CD15 (p = 0.010). Our results indicate labor length is a significant factor in neonatal neutrophil activation at birth. These findings are independent of gestational age in preterm newborns. Mode of delivery does not seem to influence neonatal neutrophil activation. The neutrophils of premature infants can be activated antenatally and/or during labor.     

In vitro effect of indomethacin on polymorphonuclear leukocyte function in preterm infants

During 1984 to 1988, the U.S. Occupational Safety and Health Administration (OSHA) investigated 10 incidents, with 11 fatalities, involving the inadvertent connection of air-line respirators to inert gas supplies. Seven deaths resulted from connecting an air-line respirator supply hose to a line which normally carried inert gas. Four deaths were caused by leakage or backfill of inert gas into a line which normally carried breathable air. Ten of the deaths were from nitrogen and one from argon. The circumstances of the 11 deaths indicated that coupling compatibility and supervisory oversight were major factors in the inappropriate supply of irrespirable gas to the respirators worn by these workers. Conscientiousness among safety personnel to the hazards of asphyxiation by inert gas, and compliance with current OSHA regulations, the ANSI Z88.2 standard, and NIOSH respirator certification approval regulations would have prevented these fatalities.     

Deformation of the palate in preterm infants

AIM: To investigate the effect of gestation, postmenstrual age, and orotracheal intubation on palate morphology. METHODS: A prospective study was made of 76 newborn infants of 25 to 41 weeks' gestation. Palate dimensions were measured on plaster models produced from serial palatal impressions. Palate size relative to that of the mouth was assessed using a ratio of palate depth to palate width (Palatal Index). RESULTS: Palate depth and width were related to postmenstrual age and gestation. Palatal Index ranged from 0.15 to 0.57, indicating a wide variation in palate shape, but gestation and postmenstrual age had no effect. Prolonged intubation had a small effect, equivalent to an increase in palatal depth of less than 2 mm at 32 weeks' postmenstrual age. The effect was transient. CONCLUSION: Prolonged orotracheal intubation (> 10 days) leads to a small and temporary increase in palatal depth. However, this is unlikely to account for palatal grooving, which is probably caused by an overgrowth of the lateral palatine ridges.     

More may not be better in psychosocial interventions for cancer patients.

Comments on the article by M. H. Antoni et al (see record 2000-14051-003) which tested the effects of a 10-week group cognitive-behavioral stress management intervention among female breast cancer patients. The authors express concern that this profession is offering interventions that patients in need cannot access and studying patients who may not be in particular need of intervention and who therefore fail to demonstrate substantial improvement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of attention in preterm infants

The quality of the awake state and attention in preterm infants has been evaluated by rating indices of attention such as widening of the eye, type of fixation, brightening, scanning, and cessation of sucking measured during visual fixation of patterns. Twenty-six infants ranging from 28 to 32 weeks' gestation at birth (mean, 31 weeks) were tested from one to four weeks postnatally until 36 weeks' gestation. Indices of attention were rated on a scale of 4 with an optimal mean index of 4. A progressive increase in behaviors associated with fixation of visual stimuli has been shown from 32 to 36 weeks of conceptual age. Mean scores ranged from 0.7 at 31 weeks' gestation to 1.8 at 34 weeks' and 2.7 at 36 weeks' gestation. The possibility therefore exists that by as early as 31 to 32 weeks from conception the human brain may be capable of waking states and thus able to process some sensory stimulation.rease in behaviors associated with fixation of visual stimuli has been shown from 32 to 36 weeks of conceptual age. Mean scores ranged from 0.7 at 31 weeks' gestation to 1.8 at 34 weeks' and 2.7 at 36 weeks' gestation. The possibility therefore exists that by as early as 31 to 32 weeks from conception the human brain may be capable of waking states and thus able to process some sensory stimulation.     

Pulmonary function tests as a predictor of chronic lung disease in ventilated preterm infants

BACKGROUND: The objective of this study was to determine if the value of respiratory system compliance and lung resistance could be a good predictor of chronic lung disease (CLD) in an early stage of this disease. METHODS: The study was carried out on 48 preterms infant (BW < 1500 g) who were ventilated for respiratory distress, calculating pulmonary mechanics at 3, 5, 7 and 10 days of life with a standardized protocol of measurements. RESULTS: Infants who did not develop CLD showed higher values of respiratory system dynamic compliance (Crsdyn) than the CLD group since the 5th day of life (p < 0.001). The values of lung resistance show a statistical significant difference between groups since the 7th day of life. CONCLUSIONS: These findings indicate that, with a well standardized method of measurements, the value of Crsdyn can well be a good predictor and a sensible prognostic factors for CLD.     

Splenic macrophages in preterm infants: a necropsy study

AIMS: To study the frequency and nature of histiocytes in the splenic red pulp of infants who died following complicated immaturity/prematurity. METHODS: Twenty four preterm/immature infants were investigated. Frozen sections of formalin fixed splenic tissue were stained with Oil Red O. Paraffin wax sections from the same tissue were conventionally stained with haematoxylin and eosin. Immunohistochemistry was carried out for a number of macrophage markers. The administration of Intralipid was compared with the presence and extent of tissue macrophages. RESULTS: The spleens of 10 infants showed varying degrees of Oil Red O positivity ranging from mild to strong. In all these cases varying numbers of macrophages were confirmed in the splenic parenchyma in ordinary sections. The immunomarkers indicated that the histiocytes belonged to the macrophage phagocytic system. Of the 10 cases with splenic macrophages all had received Intralipid. Of those not receiving Intralipid none showed splenic macrophages. Seven had received Intralipid but did not have splenic macrophages; they had either only received small amounts of Intralipid or Intralipid was discontinued before death. CONCLUSIONS: Splenic macrophages are common at necropsy in immature/preterm infants. The macrophages are most lucidly demonstrated using Oil Red O staining in frozen sections. There is a strong association between the presence of splenic macrophages and Intralipid administration.     

Psychologists in business schools: Psychological research may not always be where psychologists think it is.

Disagrees with M. Karlins's (1989) comment on the difficulties encountered by psychology PhDs in obtaining employment in business schools, based on the autobiographical experience of moving from a tenured position in psychology to a management department. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An increase in fetal plasma cortisol but not dehydroepiandrosterone sulfate is followed by the onset of preterm labor in patients with preterm premature rupture of the membranes

OBJECTIVE: The role of steroid hormones in the control of human parturition has been a subject of debate. Activation of the fetal hypothalamic-pituitary-adrenal axis leading to an increase in plasma cortisol is followed by the onset of parturition in sheep. In contrast, androgens, specifically, dehydroepiandrosterone sulfate, have been implicated in the control of parturition in nonhuman primates. The purpose of this study was to determine the relationship between human fetal plasma cortisol and dehydroepiandrosterone sulfate and the onset of preterm labor in patients with preterm premature rupture of the membranes. STUDY DESIGN: Fetal blood sampling was performed in 51 patients with preterm premature rupture of membranes who were not in labor on admission. Amniotic fluid was cultured for aerobic and anaerobic bacteria and mycoplasmas. Corticosteroids had not been administered before fetal blood sampling. Cortisol and dehydroepiandrosterone sulfate were measured with sensitive and specific immunoassays. Analysis was conducted with nonparametric statistics and survival analysis. RESULTS: (1) Patients who went into spontaneous labor and delivered within 7 days of cordocentesis had a significantly higher median level of fetal plasma cortisol but not of dehydroepiandrosterone sulfate than those delivered after 7 days (for fetal plasma cortisol: median 8.35 [4.7 to 12.4] micrograms/dL vs median 4.75 [3.0 to 10.4] micrograms/dL, P <.0001; for fetal plasma dehydroepiandrosterone sulfate: median 154.4 [8.6 to 333.8] micrograms/dL vs median 194.6 [96.7 to 402.5] micrograms/dL, P =.09). (2) The cordocentesis-to-delivery interval was significantly shorter in patients with a fetal plasma cortisol value of >/=7 micrograms/dL (derived by receiver-operating characteristic curve analysis) than in those with fetal cortisol <7 micrograms/dL (median 49 [4 to 1849] hours vs median 325 [11 to 2590] hours, P <.001). (3) Fetal plasma cortisol, but not maternal cortisol, was an independent predictor of the duration of pregnancy after we adjusted for gestational age and the results of amniotic fluid culture (hazards ratio 2.9, P <.05). (4) There was a significant correlation between fetal plasma cortisol and fetal plasma interleukin-6 (r = 0.3, P <.05). (5) A strong relationship was found between the fetal plasma cortisol/dehydroepiandrosterone sulfate ratio and the interval to delivery (P <.005). CONCLUSION: An elevation in fetal plasma cortisol but not dehydroepiandrosterone sulfate was followed by the onset of spontaneous preterm labor in patients with preterm premature rupture of the membranes.     

Evidence that the TRH-like peptide pyroglutamyl-glutamyl-prolineamide in human serum may not be secreted by the pituitary gland

A prospective, randomized, placebo-controlled, double-blind, parallel-group, 6-month study assessed the efficacy and safety of ropinirole, a nonergoline D2-dopamine agonist, in patients with early Parkinson's disease (n = 241; Hoehn & Yahr stages I to III) with limited or no prior dopaminergic therapy. Patients (mean age, 62.8 years), stratified by concomitant use of selegiline, were randomized to ropinirole (n = 116) or placebo (n = 125). The starting dose of ropinirole was 0.25 mg tid with titration to at least 1.5 mg tid (maximum dose, 8 mg tid). Primary efficacy endpoint was the percentage improvement in Unified Parkinson's Disease Rating Scale (UPDRS) motor score. Ropinirole-treated patients had a significantly greater percentage improvement in UPDRS motor score than patients who received placebo (+24% vs -3%; p < 0.001). Ropinirole was well tolerated and patient withdrawals were infrequent. Most adverse experiences were related to peripheral dopaminergic activity. Ropinirole monotherapy is an effective and well-tolerated therapeutic option for treatment of early Parkinson's disease.