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Full-term Healthy Infants (full-term + healthy_infant)
Selected AbstractsUterine rupture at scar of prior laparoscopic cornuostomy after vaginal delivery of a full-term healthy infantJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4pt2 2008Chi Feng Su Abstract A 30-year-old, gravida 2, para 0 woman who had a history of a laparoscopic cornuostomy for a left interstitial pregnancy was admitted for a vaginal delivery due to labor pains at 40 weeks gestation. A prolonged placental delivery, persistent abdominal pain, and hemorrhagic shock were noted after the delivery of the infant. An emergency laparotomy was carried out, and the diagnosis of a uterine rupture at the scar of a prior cornuostomy was confirmed. The entire placenta extruded through the rupture wound into the abdominal cavity. A Medline computer search revealed that a similar case of a uterine rupture after full-term vaginal delivery has yet to be reported. In order to prevent a uterine rupture, we suggest that a planned cesarean delivery, before the onset of labor in a subsequent pregnancy, may be safer for a patient with a scarred uterus from a prior cornuostomy for an interstitial pregnancy. [source] Association between pacifier use and breast-feeding, sudden infant death syndrome, infection and dental malocclusionINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 6 2005Ann Callaghan RN RM BNurs(Hons) Executive summary Objective, To critically review all literature related to pacifier use for full-term healthy infants and young children. The specific review questions addressed are: What is the evidence of adverse and/or positive outcomes of pacifier use in infancy and childhood in relation to each of the following subtopics: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Inclusion criteria, Specific criteria were used to determine which studies would be included in the review: (i) the types of participants; (ii) the types of research design; and (iii) the types of outcome measures. To be included a study has to meet all criteria. Types of participants,The participants included in the review were healthy term infants and healthy children up to the age of 16 years. Studies that focused on preterm infants, and infants and young children with serious illness or congenital malformations were excluded. However, some total population studies did include these children. Types of research design, It became evident early in the review process that very few randomised controlled trials had been conducted. A decision was made to include observational epidemiological designs, specifically prospective cohort studies and, in the case of sudden infant death syndrome research, case,control studies. Purely descriptive and cross-sectional studies were excluded, as were qualitative studies and all other forms of evidence. A number of criteria have been proposed to establish causation in the scientific and medical literature. These key criteria were applied in the review process and are described as follows: (i) consistency and unbiasedness of findings; (ii) strength of association; (iii) temporal sequence; (iv) dose,response relationship; (v) specificity; (vi) coherence with biological background and previous knowledge; (vii) biological plausibility; and (viii) experimental evidence. Studies that did not meet the requirement of appropriate temporal sequencing of events and studies that did not present an estimate of the strength of association were not included in the final review. Types of outcome measures,Our specific interest was pacifier use related to: ,breast-feeding; ,sudden infant death syndrome; ,infection; ,dental malocclusion. Studies that examined pacifier use related to procedural pain relief were excluded. Studies that examined the relationship between pacifier use and gastro-oesophageal reflux were also excluded as this information has been recently presented as a systematic review. Search strategy, The review comprised published and unpublished research literature. The search was restricted to reports published in English, Spanish and German. The time period covered research published from January 1960 to October 2003. A protocol developed by New Zealand Health Technology Assessment was used to guide the search process. The search comprised bibliographic databases, citation searching, other evidence-based and guidelines sites, government documents, books and reports, professional websites, national associations, hand search, contacting national/international experts and general internet searching. Assessment of quality, All studies identified during the database search were assessed for relevance to the review based on the information provided in the title, abstract and descriptor/MeSH terms, and a full report was retrieved for all studies that met the inclusion criteria. Studies identified from reference list searches were assessed for relevance based on the study title. Keywords included: dummy, dummies, pacifier(s), soother(s), comforter(s), non-nutritive sucking, infant, child, infant care. Initially, studies were reviewed for inclusion by pairs of principal investigators. Authorship of articles was not concealed from the reviewers. Next, the methodological quality of included articles was assessed independently by groups of three or more principal investigators and clinicians using a checklist. All 20 studies that were accepted met minimum set criteria, but few passed without some methodological concern. Data extraction, To meet the requirements of the Joanna Briggs Institute, reasons for acceptance and non-acceptance at each phase were clearly documented. An assessment protocol and report form was developed for each of the three phases of review. The first form was created to record investigators' evaluations of studies included in the initial review. Those studies that failed to meet strict inclusion criteria were excluded at this point. A second form was designed to facilitate an in-depth critique of epidemiological study methodology. The checklist was pilot tested and adjustments were made before reviewers were trained in its use. When reviewers could not agree on an assessment, it was passed to additional reviewers and discussed until a consensus was reached. At this stage, studies other than cohort, case,control and randomised controlled trials were excluded. Issues of clarification were also addressed at this point. The final phase was that of integration. This phase, undertaken by the principal investigators, was assisted by the production of data extraction tables. Through a process of trial and error, a framework was formulated that adequately summarised the key elements of the studies. This information was tabulated under the following headings: authors/setting, design, exposure/outcome, confounders controlled, analysis and main findings. Results, With regard to the breast-feeding outcome, 10 studies met the inclusion criteria, comprising two randomised controlled trials and eight cohort studies. The research was conducted between 1995 and 2003 in a wide variety of settings involving research participants from diverse socioeconomic and cultural backgrounds. Information regarding exposure and outcome status, and potential confounding factors was obtained from: antenatal and postnatal records; interviews before discharge from obstetric/midwifery care; post-discharge interviews; and post-discharge postal and telephone surveys. Both the level of contact and the frequency of contact with the informant, the child's mother, differed widely. Pacifier use was defined and measured inconsistently, possibly because few studies were initiated expressly to investigate its relationship with breast-feeding. Completeness of follow-up was addressed, but missing data were not uniformly identified and explained. When comparisons were made between participants and non-participants there was some evidence of differential loss and a bias towards families in higher socioeconomic groups. Multivariate analysis was undertaken in the majority of studies, with some including a large number of sociodemographic, obstetric and infant covariates and others including just maternal age and education. As might be expected given the inconsistency of definition and measurement, the relationship between pacifier use and breast-feeding was expressed in many different ways and a meta-analysis was not appropriate. In summary, only one study did not report a negative association between pacifier use and breast-feeding duration or exclusivity. Results indicate an increase in risk for a reduced overall duration of breast-feeding from 20% to almost threefold. The data suggest that very infrequent use may not have any overall negative impact on breast-feeding outcomes. Six sudden infant death syndrome case,control studies met the criteria for inclusion. The research was conducted with information gathered between 1984 and 1999 in Norway, UK, New Zealand, the Netherlands and USA. Exposure information was obtained from a variety of sources including: hospital and antenatal records, death scene investigation, and interview and questionnaire. Information for cases was sought within 2 days after death, within 2,4 weeks after death and in one study between 3 and 11 years after death. Information for controls was sought from as early as 4 days of a nominated sudden infant death syndrome case, to between 1 and 7 weeks from the case date, and again in one study some 3,11 years later. In the majority of the studies case ascertainment was determined by post-mortem. Pacifier use was again defined and measured somewhat inconsistently. All studies controlled for confounding factors by matching and/or using multivariate analysis. Generally, antenatal and postnatal factors, as well as infant care practices, and maternal, family and socioeconomic issues were considered. All five studies reporting multivariate results found significantly fewer sudden infant death syndrome cases used a pacifier compared with controls. That is, pacifier use was associated with a reduced incidence of sudden infant death syndrome. These results indicate that the risk of sudden infant death syndrome for infants who did not use a pacifier in the last or reference sleep was at least twice, and possibly five times, that of infants who did use a pacifier. Three studies reported a moderately sized positive association between pacifier use and a variety of infections. Conversely, one study found no positive association between pacifier use at 15 months of age and a range of infections experienced between the ages of 6 and 18 months. Given the limited number of studies available and the variability of results, no meaningful conclusions could be drawn. Five cohort studies and one case,control study focused on the relationship between pacifier use and dental malocclusion. Not one of these studies reported a measure of association, such as an estimate of relative risk. It was therefore not possible to include these studies in the final review. Implications for practice, It is intended that this review be used as the basis of a ,best practice guideline', to make health professionals aware of the research evidence concerning these health and developmental consequences of pacifier use, because parents need clear information on which they can base child care decisions. With regard to the association between pacifier use and infection and dental malocclusion it was found that, due to the paucity of epidemiological studies, no meaningful conclusion can be drawn. There is clearly a need for more epidemiological research with regard to these two outcomes. The evidence for a relationship between pacifier use and sudden infant death syndrome is consistent, while the exact mechanism of the effect is not well understood. As to breast-feeding, research evidence shows that pacifier use in infancy is associated with a shorter duration and non-exclusivity. It is plausible that pacifier use causes babies to breast-feed less, but a causal relationship has not been irrefutably proven. Because breast-feeding confers an important advantage on all children and the incidence of sudden infant death syndrome is very low, it is recommended that health professionals generally advise parents against pacifier use, while taking into account individual circumstances. [source] Resistance index in fetal interlobar renal artery with renal pelvic dilatation up to 10 mmJOURNAL OF CLINICAL ULTRASOUND, Issue 2 2003Simay Altan Kara MD Abstract Purpose The purpose of this study was to compare the resistance indices (RIs) in the fetal interlobar renal arteries (IRAs) of third-trimester fetuses with or without pelvicaliceal dilatation of up to 10 mm and to compare them with those of the full-term healthy infants. Methods Women with uncomplicated, low-risk, singleton third-trimester pregnancies were examined sonographically. The RIs in the IRAs were measured in the fetuses, who were stratified into 3 groups according to the anteroposterior diameter of the renal pelvic dilatation: group I, no dilatation; group II, 1,5-mm dilatation, and group III, 6,10-mm dilatation. Results In total, 178 women were examined. We could study both kidneys in 139 of the fetuses; in the other 39, only 1 kidney could be imaged perfectly. This yielded a total of 317 kidneys. Group I fetuses included 172 (54%); group II, 98 (31%); and group III, 47 (15%) of the kidneys. The mean (± standard deviation) RIs in the IRAs were 0.81 ± 0.09, 0.80 ± 0.07, and 0.80 ± 0.06 in the 3 groups, respectively, with no statistically significant difference between the groups (p = 0.72). There was also no statistically significant difference between the RIs recorded in the right and left kidneys. The mean RI in the IRAs of the 34 infants who were available for follow-up 6,12 weeks after delivery was 0.73 ± 0.07, which was significantly less than that recorded in the third-trimester fetuses (p = 0.005). Conclusions The RI in the fetal IRA does not differ in fetuses with and without renal pelvic dilatation of up to 10 mm. Thus, an increase in the RI or an RI that significantly differs between the right and left kidneys should be investigated further for possible renal pathology. © 2003 Wiley Periodicals, Inc. J Clin Ultrasound 31:75,79, 2003 [source] Gender differences in early accommodation and vergence developmentOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 2 2008Anna M. Horwood Abstract A remote haploscopic photorefractor was used to assess objective binocular vergence and accommodation responses in 157 full-term healthy infants aged 1,6 months while fixating a brightly coloured target moving between fixation distances at 2, 1, 0.5 and 0.33 m. Vergence and accommodation response gain matured rapidly from ,flat' neonatal responses at an intercept of approximately 2 dioptres (D) for accommodation and 2.5 metre angles(MA) for vergence, reaching adult-like values at 4 months. Vergence gain was marginally higher in females (p = 0.064), but accommodation gain (p = 0.034) was higher and accommodative intercept closer to zero (p = 0.004) in males in the first 3 months as they relaxed accommodation more appropriately for distant targets. More females showed flat accommodation responses (p = 0.029). More males behaved hypermetropically in the first two months of life, but when these hypermetropic infants were excluded from the analysis, the gender difference remained. Gender differences disappeared after three months. Data showed variable responses and infants could behave appropriately and simultaneously on both, neither or only one measure at all ages. If accommodation was appropriate (gain between 0.7 and 1.3; r2 > 0.7) but vergence was not, males over- and under-converged equally, while the females who accommodated appropriately were more likely to overconverge (p = 0.008). The apparent earlier maturity of the male accommodative responses may be due to refractive error differences but could also reflect gender-specific male preference for blur cues while females show earlier preference for disparity, which may underpin the earlier emerging, disparity dependent, stereopsis and full vergence found in females in other studies. [source] Body composition in full-term healthy infants measured with air displacement plethysmography at 1 and 12 weeks of ageACTA PAEDIATRICA, Issue 4 2010Britt Eriksson Abstract Aim:, To use Pea Pod, a device based on air displacement plethysmography, to study body composition of healthy, full-term infants born to well-nourished women with a western life-style. Methods:, Body composition was assessed in 53 girls and 55 boys at 1 week (before 10 days of age) and at 12 weeks (between 77 and 91 days of age). Results:, At 1 week girls contained 13.4 ± 3.7% body fat and boys 12.5 ± 4.0%. At 12 weeks, these figures were 26.3 ± 4.2% (girls) and 26.4 ± 5.1% (boys). Body fat (%) did not differ significantly between the genders. Body fat (%) at the two measurements was not correlated. At 1 week, the weight (r = 0.20, p = 0.044) and BMI (r = 0.26, p = 0.007) of the infants, but not their body fat (g, %) or fat free mass (g), correlated with BMI before pregnancy in their mothers. Conclusions:, Pea Pod has potential for use in studies investigating the effect of external (i.e. nutritional status) and internal (i.e. age, gender, gestational age at birth) factors on infant body composition. This may be of value when studying relationships between the nutritional situation during early life and adult health. [source] Bradycardic response during submersion in infant swimmingACTA PAEDIATRICA, Issue 3 2002E Goksör The diving response involves reflex bradycardia, apnoea and peripheral vasoconstriction and is known to exist in human infants. The response diminishes with increasing age and has been reported to disappear by the age of 6 mo. This study was performed to analyse the physiological events during natural diving of full-term healthy infants and describe how these events alter with maturation. Thirty-six infants were studied during diving exercises in infant swimming. All of the infants who participated showed an immediate decrease in heart rate when submerged. On average, the heart rate decreased by 25% (range ,5.0% to ,50.7%, p < 0.0001). The bradycardia was sustained during the dive and for some seconds afterwards. The response was often followed by a tachycardia as the bradycardia ceased. A decline of reflex bradycardia was observed with increasing age (p= 0.03), but the response was still clearly evident in infants over the age of 6 mo. Conclusion: This study demonstrates the existence of a diving response in infants, which includes an immediate bradycardic response, suggesting vagal mediation. Although the bradycardic response gradually decreases, the study shows that a clear-cut response exists in children older than has previously been reported. [source] | ||||||||||