Immunization has no effect on arousal from sleep in the newborn infant

Protection against enteric infections can be provided by the oral administration of pathogen-neutralizing antibodies. To provide passive immunity, 18 lines of transgenic mice secreting a recombinant monoclonal antibody (Mab) neutralizing transmissible gastroenteritis coronavirus (TGEV) into the milk were generated. The genes encoding a chimeric Mab with the variable modules of the murine TGEV-specific Mab 6A.C3 and the constant modules of a human IgG, isotype Mab were expressed under the control of regulatory sequences derived from the whey acidic protein, which is an abundant milk protein. The Mab 6A.C3 binds to a highly conserved epitope present in coronaviruses of several species, which does not allow the selection of neutralization escape mutants. Antibody expression titers of 10(6) were obtained in the milk of transgenic mice that reduced TGEV infectivity 10(6)-fold. The antibody was synthesized at high levels throughout lactation. Integration of matrix attachment region sequences with the antibody genes led to a 20- to 10,000-fold increase in the antibody titer in 50% of the transgenic animals. Antibody expression levels were transgene copy number independent and related to the site of integration. The generation of transgenic animals producing virus neutralizing antibodies in milk could provide an approach to protection against neonatal infections of the enteric tract.     

Premature infant responses to noise reduction by earmuffs: effects on behavioral and physiologic measures

The continuous high-intensity noise in the neonatal intensive care unit (NICU) is both stressful and harmful for the premature infant. Although some researchers have found evidence that loud noise can cause hearing loss and alter physiologic and behavioral responses, no study to date has investigated the benefits of noise reduction by the use of earmuffs. In this study earmuffs were placed over the premature infants' ears to reduce noise intensity in the NICU while physiologic and behavioral responses were measured. Two sites were used to collect data: in the first setting, 17 low birth weight infants were randomly assigned to an experimental and a control group, whereas 13 infants from a second hospital acted as their own controls and were tested with and without earmuffs. Earmuffs that reduced the intensity of noise by 7 to 12 dB were worn by infants in the experimental group only during the observation periods. Infants in the control group were exposed to the usual noise in the NICU. The infant's physiologic and behavioral responses were observed for four 2-hour intervals, morning and evening, on two consecutive days. Most of the significant results were from the site at which infants acted as their own controls. When infants wore the earmuffs, they had significantly higher mean oxygen saturation levels and less fluctuation in oxygen saturation. Furthermore, these infants had less frequent behavioral state changes, spent more time in the quiet sleep state, and had longer bouts in the sleep state. It is imperative that NICUs develop aggressive antinoise policies to substantially and consistently reduce noise.     

Protein: metabolism and effect on blood glucose levels

Insulin is required for carbohydrate, fat, and protein to be metabolized. With respect to carbohydrate from a clinical standpoint, the major determinate of the glycemic response is the total amount of carbohydrate ingested rather than the source of the carbohydrate. This fact is the basic principle of carbohydrate counting for meal planning. Fat has little, if any, effect on blood glucose levels, although a high fat intake does appear to contribute to insulin resistance. Protein has a minimal effect on blood glucose levels with adequate insulin. However, with insulin deficiency, gluconeogenesis proceeds rapidly and contributes to an elevated blood glucose level. With adequate insulin, the blood glucose response in persons with diabetes would be expected to be similar to the blood glucose response in persons without diabetes. The reason why protein does not increase blood glucose levels is unclear. Several possibilities might explain the response: a slow conversion of protein to glucose, less protein being converted to glucose and released than previously thought, glucose from protein being incorporated into hepatic glycogen stores but not increasing the rate of hepatic glucose release, or because the process of gluconeogenesis from protein occurs over a period of hours and glucose can be disposed of if presented for utilization slowly and evenly over a long time period.     

The effect of sleep on conscious sedation

This study evaluated the effect of preoperative sleep on the success of conscious sedation. Thirty healthy children between the ages of 18 and 61 months of age were utilized in this study. The children all received chloral hydrate (50-60 mg/kg) and hydroxyzine (15-25 mg) and nitrous oxide (30-50%). Parents were asked to complete a questionnaire which asked several questions about their child's activity the previous day, their diet, and questions that related to their bedtime. The operator ranked the sedations on a scale from 1 to 4 with 1 being good and 4 being poor. The results were then statistically evaluated using the non-parametric Mann-Whitney and Kruskal-Walls tests. The children that received a normal amount of sleep or greater amount of sleep preoperatively had a borderline (P = .06) higher degree of successful sedation. There was no correlation between the child's bedtime (early, normal, late) and the success of sedation. The parent's perception of their child's tiredness could not be correlated with the success of the sedation. The children greater than 36 months of age had a significantly (P = .02) higher degree of successful sedations. The results suggest that a well rested child may experience a more pleasant dental sedation while under chloral hydrate and hydroxyzine conscious sedation and that the child's age at the time of the sedation may affect the outcome of the sedation.     

Spatial receptive fields of primary auditory cortical neurons in quiet and in the presence of continuous background noise

Spatial receptive fields of primary auditory (AI) neurons were studied by delivering, binaurally, synthesized virtual-space signals via earphones to cats under barbiturate anesthesia. Signals were broadband or narrowband transients presented in quiet anechoic space or in acoustic space filled with uncorrelated continuous broadband noise. In the absence of background noise, AI virtual space receptive fields (VSRFs) are typically large, representing a quadrant or more of acoustic space. Within the receptive field, onset latency and firing strength form functional gradients. We hypothesized earlier that functional gradients in the receptive field provide information about sound-source direction. Previous studies indicated that spatial gradients could remain relatively constant across changes in signal intensity. In the current experiments we tested the hypothesis that directional sensitivity to a transient signal, as reflected in the gradient structure of VSRFs of AI neurons, is also retained in the presence of a continuous background noise. When background noise was introduced three major affects on VSRFs were observed. 1) The size of the VSRF was reduced, accompanied by a reduction of firing strength and lengthening of response latency for signals at an acoustic axis and on-lines of constant azimuth and elevation passing through the acoustic axis. These effects were monotonically related to the intensity of the background noise over a noise intensity range of approximately 30 dB. 2) The noise intensity-dependent changes in VSRFs were mirrored by the changes that occurred when the signal intensity was changed in signal-alone conditions. Thus adding background noise was equivalent to a shift in the threshold of a directional signal, and this shift was seen across the spatial receptive field. 3) The spatial gradients of response strength and latency remained evident over the range of background noise intensity that reduced spike count and lengthened onset latency. Those gradients along the azimuth that spanned the frontal midline tended to remain constant in slope and position in the face of increasing intensity of background noise. These findings are consistent with our hypothesis that, under background noise conditions, information that underlies directional acuity and accuracy is retained within the spatial receptive fields of an ensemble of AI neurons.     

The effect of densensitization on the sleep and dreams of a phobic subject.

Studied the sleep and dreams of a 22-yr-old male undergraduate who had complained of fear of noise and closed spaces and had consequently undergone 9 1-hr desensitization sessions within a 2-wk period. On 11 nights, prior to, during, and after sensitization training, the S slept in an air-conditioned, sound-proof experimental room while his physiological responses were monitored. The 1st 2 nights were adaptation nights, the 3rd night was a dream collection night, and the remaining 8 nights consisted of 2 blocks of nonconsecutive nights which were used to record uninterrupted sleep or to collect dreams. Upon being awakened on dream nights, the S reported dream content and rated each dream on a modified version of the Nowlis Mood Adjective Checklist (NMAC). Data show that time to get to sleep (associated with anxiety), REM density (associated with bizarreness and emotionality), and 2 inner-focused negative affect dimensions of the NMAC exhibited a 'U'-shaped function over the course of the study. Findings indicate that removal of affective discharge from what were usually disturbing stimuli reduced the effects of such stimuli on sleep and dreams. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Environmental noise as a cause of sleep disruption in an intermediate respiratory care unit

Our laboratory previously reported continuously monitored peak sound levels in several areas at Rhode Island Hospital. The number of sound peaks greater than 80 A-weighted decibels (dBA) was found to be high in the intensive and intermediate respiratory care unit (IRCU) areas, even at night. Environmental noise of this magnitude is potentially sleep-disruptive. Therefore, we hypothesized that nocturnal peak sound levels of > or = 80 dBA would be associated with an increase in EEG arousals from sleep in patients in the IRCU. Six patients underwent sleep monitoring while environmental peak sound levels were continuously recorded. Each 8-hour period (2200 to 0600 hours) was broken down into 30-minute segments. If there were 10 minutes or more of wakefulness in a segment, that segment was dropped from further analysis. Of the remaining 61 segments, there was a very strong correlation (r = 0.57, p = 0.0001) between the number of sound peaks of > or = 80 dBA and arousals from sleep. These 61 periods were then classified as quiet, moderately loud, and very loud based on the number of sound peaks (< or = 5, 6-15, and > 15, respectively). Analysis of variance revealed a significant difference between the number of arousals (p = 0.001) in quiet periods and that in very loud periods. We conclude that environmental noise may be an important cause of sleep disruption in the IRCU.     

Is Tourette syndrome a cause of sudden infant death syndrome and childhood obstructive sleep apnea?

The cause of sudden infant death syndrome (SIDS) is unknown. Sleep-related impairment of respiratory control and arousal are postulated; hyperdopaminergic and hyposerotonergic dysfunction may contribute to events leading to infant apnea and SIDS. Psychosocial adversity and impulsive and compulsive behaviors characterize some families of SIDS victims. Tourette syndrome (TS) is a common hereditary neurobehavioral disorder characterized by the frequent presence of impulsive and compulsive behaviors. Sleep disorders are common and include sleep apnea and abnormal arousal. Hyperdopaminergic and hyposerotonergic abnormalities are postulated to contribute to the pathophysiology of the disorder. The following is a report of the presence of incidents of infant apnea and SIDS in families in which TS was present. In an additional TS family, a child had obstructive sleep apnea syndrome (OSAS). Results of a preliminary survey suggest that TS gene carriers are at increased risk of life-threatening apneas of infancy and that the prevalence of SIDS in such families may be 2 to 5 times the prevalence in the general population. The presence in some pedigrees of sleep apnea in children and adults suggest that in some instances disorders of sleep-related ventilatory control and arousal occurring throughout the life-span share common pathophysiological mechanisms.     

Restitutive effect of sleep on chronic performance stress

During a polysomnographic (2 nights) sleep registration of 5 chronically stressed compared to 5 control persons 24 h blood cortisol values and salivary cortisol at daytime were measured and compared with measured stress vulnerability. While daytime cortisol levels were reduced under stress conditions, during night sleep combined with a significant change in sleep architecture cortisol excretion raised markedly compared to controls, and the cortisol response to CRF provocation is no more blunted but activated beyond controls, demonstrating the restitutive and protective effect of sleep.     

The effect of labor on olfactory exposure learning within the first postnatal hour.

Thirty-one neonates delivered by cesarean section were exposed to an odor for 30 min shortly after birth. Fifteen births had uterine labor contractions before delivery; 16 were without contractions. All babies were later tested (median age = 80 hr) for their responses to the familiar exposure odor and a novel odor presented on either side of the face. Overall, the babies spent more time turned toward the exposure odor than toward the novel scent. Babies in the labor condition, but not those born without labor, displayed a significant preference for the exposure odor. Norepinephrine (NE) levels were higher in babies who oriented preferentially toward the exposure odor. Brief exposure immediately after birth is sufficient for the development of olfactory learning. Heightened learning by neonates from births with contractions may reflect locus coeruleus and NE activation. Olfactory learning may therefore be particularly efficient shortly after birth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of mood on sleep onset latency and REM sleep in interepisode bipolar disorder.

The present study investigates whether interepisode mood regulation impairment contributes to disturbances in sleep onset latency (SOL) and rapid eye movement (REM) sleep. Individuals with interepisode bipolar disorder (n = 28) and healthy controls (n = 28) slept in the laboratory for 2 baseline nights, a happy mood induction night, and a sad mood induction night. There was a significant interaction whereby on the happy mood induction night the bipolar group exhibited significantly longer SOL than did the control group, while there was no difference on the baseline nights. In addition, control participants exhibited shorter SOL on the happy mood induction night compared to the baseline nights, a finding that was not observed in the bipolar group. On the sad mood induction night, participants in both groups had shorter SOL and increased REM density when compared to the baseline nights. Bipolar participants exhibited heightened REM density compared to control participants on both nights. These results raise the possibility that regulation of positive stimuli may be a contributor to difficulties with SOL, while hyperactivity may be characteristic of REM sleep. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of infant irritability on mother-infant interaction: A growth-curve analysis.

To further understanding of temperament–interaction relationships, patterns of interactive behavior were observed longitudinally (at 1, 2, 3, 4, 5, and 6 mo) in 30 lower-class dyads (15 irritable, 15 nonirritable). Frequency data were analyzed by using multilevel analysis to assess the changing nature of the behaviors. Findings revealed that irritable infants differ from nonirritable infants both in amount and growth trajectory of positive and negative emotionality and in amount of environmental interest. Mothers of irritable infants differ from those of nonirritable infants in both amount and growth trajectory of visual contact, effective stimulation, physical contact, soothing, noninvolvement, and responsiveness to positive signals. Maternal behavior was systematically more positive in nonirritable compared with irritable infants. Findings are discussed in terms of current temperament theories that stress the possibility of developmental changes in the expression of early temperament. (PsycINFO Database Record (c) 2010 APA, all rights reserved)