Accommodative esotropia during the first year of life

Two infants developed accommodative esotropia during their first six months of life. One infant, whose age at onset was 4 1/2 months, had 4.50 diopters of hyperopia. The second infant, whose age at onset was 5 months, had 3.50 diopters of hyperopia. In both infants, the eyes completely aligned with hyperopic correction. Two points are stressed. First, when the amount of hyperopia exceeds +3.00, consideration should be given to an accommodative element as the cause of the esotropia, even if the child is only 4 to 6 months old. Second, even with small angles of esotropia, an accommodative element should be considered, if there is a substantial amount of hyperopia.     

Psychophysiological correlates of emotional reactivity during the first year of life.

Emotional reactivity is an important dimension thought to underlie individual differences in infant temperament. In a series of studies, we have examined the relation between behaviors reflecting this dimension and measures of heart rate variability. In the current study, longitudinal behavioral data on two groups of infants selected for their pattern of heart period variability are presented: those with high vagal tone (high heart rate variability) and those with low vagal tone (low heart rate variability) at 14 months of age. The data suggest that infants with high vagal tone were more reactive to both positive and negative events at 5 months and more sociable and approachful at 14 months. Infant reactivity to mildly stressful events seems to be a stable dimension during the first year, and there is a strong association between differences in reactivity and the degree to which the autonomic nervous system is influenced by vagal tone. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aortic coarctation. Treatment under one year (author's transl)

Fifteen patients operated upon for aortic coarctation under one year are reported. Nine of them survived. The E.C.G. was very useful as far as the surgical prognosis is concerned. Dead patients showed either right or biventricular hypertrophy, with alteration of the repolarisation. On the other hand 50% of survivors had left ventricular hypertrophy. In six of the operated patients a plasty between subclavian artery and aortic arch was performed. The remaining patients were treated by end-to-end anastomosis.     

Respiratory mechanics of the horse during the first year of life

This study investigated the developmental changes in the mechanical properties of the respiratory system in growing horses. Pulmonary mechanics and lung volumes were serially measured in anesthetized foals during the first year of life. Quasi-static pressure-volume curves were generated, and functional residual capacity (FRC) was measured using a closed nitrogen equilibration technique. At birth, chest wall compliance normalized to body weight was substantially less than that reported in other less precocious newborn species, while lung compliance normalized to body weight was similar to values reported for other species. Characteristics of the transition from the neonatal to adult respiratory system in the foal included a decrease in the ratios of chest wall to lung compliance (Cw/CL) and the unstressed volume of the chest wall to TLC, and a constant FRC/TLC throughout most of the study period. The somatic growth of the foal and its respiratory system were uneven processes, with increases in lung volume lagging increases in overall body size.     

Attachment, maternal sensitivity, and infant temperament during the first year of life.

Families were examined at 6, 9, and 12 months in an intensive longitudinal study that included Home Behavior Attachment Q-sorts, laboratory Strange Situation assessment, home observations of infant temperament behavior on 24 occasions, observations of maternal parenting sensitivity on 12 occasions, and maternal reports of infant temperament. Maternal sensitivity was modestly related to Q-sort security and unrelated to Strange Situation classification. In contrast, observed infant temperament was more strongly related to both maternal sensitivity and Q-sort security. The relation between home and laboratory assessment of attachment security, which was at the level found in prior work ( e.g., B. E. Vaughn & E. Waters, 1990 ), remained after the effects of observed and mother reported infant temperament were partialed. Our data highlight the need to consider other factors besides maternal sensitivity in the explanation of variability in the attachment status of l-year-olds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spontaneous intracranial hemorrhage of structural origin during the first year of life

Symptomatic intracranial hemorrhage (ICH) in term infants is not common, but when it occurs it is usually secondary to trauma, coagulation disorders and/or hypoxia. The possibility of a structural cause for an infantile ICH is unfortunately not seriously considered until very late. In this paper we report the cases of five full-term infants, each of whom developed ICH secondary to a structural lesion during the 1st year of life. Three presented during the newborn period. A congenital saccular aneurysm of the middle cerebral artery in an 8-month old male infant; a posterior fossa arteriovenous malformation in a 2-week old female neonate; a deep parietal cavernous angioma in a 6.5-month-old male infant; a temporoparietal low-grade astrocytoma in a 12-day old male neonate and a temporoparietal desmoplastic ganglioglioma in a 9-day-old male neonate were the structural lesions that were causative for hemorrhage. In all cases but one, the diagnosis was reached by computerized tomography and/or magnetic resonance imaging. All infants underwent surgery for the removal of the hematoma and of the lesion causative for the bleed. All are alive at 19, 3, 11.5, 10, and 5 years, respectively. We discuss the diagnosis of ICH with special emphasis on contemporary imaging modalities and stress the benefits of aggressive and timely surgical treatment. We then consider a concise analysis of the world literature on the occurrence of structural causes of ICH during infancy.     

Assessment of mastery motivation during the first year of life: Contemporaneous and cross-age relationships.

Assessed 68 firstborns at 6 and 12 mo with 12 mastery tasks chosen to elicit 3 aspects of mastery motivation: effect production, practicing sensorimotor skills, and problem solving. Ss were also administered the Bayley Scales of Infant Development (BSID). The significant contemporaneous and cross-age relationships suggest complex interactions at 6 and 12 mo between each S's developmental level, nature of the task, and mastery motivation. The cross-age relationships indicate a developmental progression in mastery behavior during the 1st yr. This progression is one in which a highly motivated child is persistent in producing effects at 6 mo, becomes persistent in practicing sensorimotor skills, and engages in exploration of problem-solving tasks at 12 mo. The relationships with the BSID suggest that mastery motivation and developmental competence are interrelated and that mastery becomes more differentiated with age. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vitamin E and C levels in infants during the first year of life

The considerably lower vitamin E level found in cord blood and in newborns at birth than those found in the venous blood of mothers at delivery are not yet fully explained. In a group of 217 not selected newborns, we attempted to establish the relation between vitamin E and C levels at delivery and the changes during the first year of life. The mean serum vitamin E level rose from 0.37 mg/ml at 3 days to 0.80 mg/100 ml at 6 months and to 0.72 mg/100 ml at 12 months. On the other hand vitamin C mean levels lowered from 0.93 mg/100 ml in cord blood to 0.77 mg/100 ml at 6 months and to 0.73 mg/100 ml at 12 months. The rise of vitamin E values could be explained by the early use of infant solid foods with high vitamin and mineral content and by the increase of serum lipoproteins. Except at 3 days after delivery there were no individual values of serum vitamin E below the acceptable 0.35 mg/100 ml limit. However, serum vitamin C levels compatible with a moderate risk were very often observed, i.e., in 27.1% of infants at 6 months and in 30.5% at 1 year. Thus, vitamin E intake in infants was satisfactory with the usual diet but not vitamin C for which blood levels were not adequate. In view of these findings it appears necessary to evaluate periodically the vitamin E as well as vitamin C status in the infant population.     

Nasopharyngeal colonization in Costa Rican children during the first year of life

BACKGROUND: The establishment of the nasopharyngeal flora was followed in Costa Rican children from birth to 1 year of age. METHODS: Nasopharyngeal cultures were obtained at 1 (n = 413), 3 (n = 393), 6 (n = 376) and 12 months (n = 356) of age from children representative of the population in the Puriscal district. Weekly cultures were obtained from a subcohort of these children (n = 101). Mother-infant diads (n = 95) and preschool children (n = 208) attending day-care centers were also studied. RESULTS: The estimated proportion of colonized children in the population differed markedly depending on the frequency of culture. Quarterly cultures showed a slow increase in carrier rates from 3.9% for Haemophilus influenzae, 3.1% for Streptococcus pneumoniae and 6.5% for Moraxella catarrhalis at 1 month of age to 10.1% carrying H. influenzae and 19.4% carrying S. pneumoniae by the end of the first year. By quarterly culture the proportion of children colonized at least once was 36% for S. pneumoniae, 26% for H. influenzae and 28% for M. catarrhalis. In contrast weekly sampling showed that 95 to 100% of the children were colonized at least once during the first year of life with H. influenzae, S. pneumoniae or M. catarrhalis. Nasopharyngeal carriage of H. influenzae, S. pneumoniae and M. catarrhalis was low in the mothers, and very few mother-infant pairs carried identical bacteria at the same time. In contrast carrier rates were high in the siblings attending day care (H. influenzae 27.9%, S. pneumoniae 39.4%, both organisms 26.6%). Infants with siblings had significantly higher bacterial carriage at all ages than infants without siblings. CONCLUSIONS: Quarterly nasopharyngeal cultures showed that Costa Rican infants acquire their nasopharyngeal flora at a rate comparable with that for infants in developed countries and that siblings are an important source of the bacteria. Weekly samplings showed that virtually all children were colonized at least once during the first year of life.     

Morbidity during the first year of life in small for gestational age infants

OBJECTIVE: To study the effect of early postnatal dexamethasone (days 1-3) on the incidence and severity of chronic lung disease in preterm infants with respiratory distress syndrome. METHODS: A multicentre, randomised, placebo controlled, blinded study was carried out in 18 neonatal intensive care units in Israel. The primary outcome measure was survival to discharge without requirement for supplemental oxygen therapy beyond 28 days of life. The secondary outcome measures were requirement for mechanical ventilation at 3 and 7 days, duration of ventilation or oxygen therapy, need for subsequent steroids for established chronic lung disease and incidence of major morbidities. RESULTS: The study consisted of 248 infants (dexamethasone n = 132; placebo n = 116). No differences were found in the outcome variables except for a reduction in requirement for mechanical ventilation at age 3 days in treated infants (dexamethasone 44%, placebo 67%; P = 0.001). Gastrointestinal haemorrhage, hypertension, and hyperglycaemia were more common in treated infants, but no life threatening complications, such as gastrointestinal perforation, were encountered. CONCLUSIONS: These data do no support the routine use of early postnatal steroids, but may justify further study in a selected, high risk group of infants.     

Candida endocarditis in the first year of life

Candida is an increasing problem as a causal agent of nosocomial infection in neonates and infants. We report 15 cases of infective endocarditis caused by Candida spp treated at the Hospital Infantil de Mexico between 1980 and 1991. The diagnosis of endocarditis was established by the identification of Candida in at least two blood cultures and echocardiographic assessment. From 110 cases of systemic candidiasis during the eleven years period of study, fifteen patients presented endocarditis (13.6%), all had a central venous catheter. Three had antecedent of congenital heart disease. Candida isolation was obtained an average of 28 days after admission. The major clinical findings were: fever in 13 patients, respiratory distress and cardiac murmurs observed in nine respectively. Thrombocytopenia was present in eight children. The echocardiographic evaluation showed vegetations located in the superior vena cava in six, right atrium in five, tricuspid valve in two, inferior vena cava and right ventricle in one respectively. Three cases were subjected to surgical treatment. Nine patients died for a case fatality rate of 60%. The echocardiographic evaluation practiced in all patients with suspicion of systemic candidiasis is critical for the prognosis. The identification of endocardiac involvement coupled with the opportune administration of antifungal therapy and surgical treatment may improved the survival.     

Sociability with peer and mother during the first year.

32 infants were videotaped with their mothers and a peer 9 times (3 visits at 6, 9, and 12 mo). Three hypotheses concerning the social behaviors were examined: that interactions with mother and peer differ in characteristic activities and functions, that interactions with peers grow out of earlier mother–infant interactions, and that behaviors with the 2 partners are characterized by underlying consistency. Support for the 1st and 3rd hypotheses was found. Ss were more likely to look at and vocalize to the peer but were more likely to touch the mother. A negative correlation was found between the frequencies of Ss' touching mother and touching peer. The absence of toys affected the 2 systems similarly, and similar patterns of growth were apparent over time. Significant positive correlations were found between the frequencies of the smiles and vocalizations to the 2 partners. In light of these results, a model is proposed in which underlying infant sociability is reflected somewhat differentially with mother and peer. Reasons for the lack of support of the precursor hypothesis are explored. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning via observation during the second year of life.

Studied deferred imitation of object-related actions in 82 12–13 mo olds and in 85 18–29 mo olds to examine the development of competence in observational learning. Three task categories were investigated: simple/single actions, reiterative actions, and sequentially coordinated actions. Results show evidence for deferred imitation for the simple/single actions at 12 mo. When the simple/single action component was isolated in the more complex tasks and its achievement scored, deferred imitation was determinable for additional actions. At 18 mo, improvements occurred in observational learning for all 3 task categories. However, even at 18 mo, serial and sequential coordinations were accomplished by fewer than half of the Ss who had observed actions with these properties. Examination of partial successes at both ages suggested phases in the information sequence. In these phases, encoding was probably inadequate, and action schemes were probably insufficiently differentiated for Ss to fully profit from modeling. Findings suggest that imitative ability is in an early developmental phase by the end of the 1st yr and that information-processing characteristics have more demonstrable effects during the 2nd yr of life. (24 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of eye–hand coordination in the first year of life.

The traditional reflex-to-voluntary behavior model of development is questioned, and an alternative hypothesis is proposed that reflex functions are distinct from the ontogenetic antecedents of voluntary behavior. An overview of patterns of eye–hand coordination in the 1st yr of life suggests that reflexes and cortically controlled instrumental activity share a parallel course of development, with the latter increasing in frequency and importance as development proceeds. Despite procedural problems in studying neonatal reaching there remains sufficient evidence that hand movements in infants under 8 wks of age are progressively coordinated with visual stimuli. Some new data are presented that show that up to at least 12 wks of age the left hand shows greater activity and orientation to visual stimuli than the right hand, which is contralateral to the dominance of neonatal reflexes. Experiments are reviewed that have studied the emergence of visually guided reaching and its development during the 2nd half of the 1st yr. The evidence is consistent with the hypothesis that this apparently new behavior, clearly distinct from reflexes, is in fact on a continuum with these earlier nonreflexive, instrumental behaviors. (French abstract) (79 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support and stress during the first year of graduate school.

Describes the effects of varying levels of social interaction on 22 1st-yr graduate students' reports of stressful events and on their health and emotional problems during the 1st 6 mo of graduate study. Ss completed 2 questionnaires partially drawn from the Graduate Student Questionnaire. They also recorded their social contacts. An inverse relationship was found between frequency of social interactions with peers and faculty during the 1st 10 wks of study and the incidence of stressful life events and the number of reported physical and psychological disturbances throughout the next 6 mo. The quality of faculty–student interactions also emerged as an important factor that moderated the negative consequences of the major life changes associated with beginning graduate school. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)