Early intervention for low-birth-weight premature infants: what can we achieve?

Low-birth-weight (LBW) premature infants are at increased risk for abnormal development. It is unclear whether intervention programs designed to prevent the disabilities in preterm children are efficacious. This paper reviews the settings in which interventions take place (e.

Fetal growth and cardiovascular risk factors in Jamaican schoolchildren.

Objective: To determine relation between schoolchildren's blood pressure, glycated haemoglobin level, and cholesterol concentration and their anthropometry, socioeconomic status, and birth measurements.

Design: Retrospective cohort study.

Setting: 27 schools closest to University Hospital of the West Indies, Kingston, Jamaica.

Obesity in peoples of the African diaspora.

People of African descent in the Caribbean and the USA originated from the Bight of Benin in West Africa. Although these populations share a common genetic heritage, they now live under different socioeconomical conditions. Assuming genetic similarity, a cross-cultural examination of these peoples in West Africa, the Caribbean and the USA may attenuate the effect of genetic factors and allow the assessment of environmental contributions to a biological outcome.

Obesity in the Caribbean.

People of African origin who live in the Caribbean share a common genetic heritage but live in socioeconomic environments that diverge widely. A cross-cultural study of males and females from Jamaica, St. Lucia and Barbados investigated the prevalence of hypertension and its environmental determinants.

Breaking the news. How families first learn about their child's chronic condition.

Objective: To develop recommendations for effectively informing families about their child's chronic illness or disability.

Methods: The sample included 43 families of infants with Down syndrome and/or congenital heart disease who were participating in Project Resilience, which is a multisite longitudinal research project. Family interviews were transcribed verbatim and coded by two raters.

Outcome of infants weighing less than 800 grams at birth: 15 years' experience.

Objective: Mortality and neurodevelopmental morbidity among infants weighing less than 800 g at birth are compared in three separate studies from the same intensive care nursery during an almost 15-year period.

Methods: The survival and neurodevelopmental outcome of 210 infants with birth weights less than 800 g admitted to the University of Washington neonatal intensive care unit between 1986 and 1990 are compared with those of two previous cohorts (1977 through 1980 and 1983 through 1985) of extremely low birth weight (ELBW) infants from the same nursery.

Results: Annual admissions of these ELBW infants nearly doubled from 1977 to 1990, whereas nursery survival rose from 20% between 1977 and 1980, to 36% between 1983 and 1985, to 49% in this current study of births between 1986 and 1990.

Preventive interventions with low birth weight premature infants: an evaluation of their success.

The outcome literature on low birthweight (LBW) premature children indicates that they are at risk for a variety of neurodevelopmental impairments throughout childhood. To prevent such disabilities, numerous interventions have been initiated with LBW children. Nineteen intervention programs designed for LBW preterms that have published study results dating from 1971 are reviewed.

Evidence for the location of a binding sequence for the alpha 2 beta 1 integrin of endothelial cells, in the beta 1 subunit of laminin.

To date no specific location on laminin 1 for the binding of alpha 2 beta 1 integrin has been described, although recent evidence supports a location in the E1XNd fragment of the cross region. We have identified a peptide sequence from this region, in the beta 1 chain of laminin 1, YGYYGDALR, which inhibits the adhesion of endothelial cells to laminin 1 and type-IV collagen. A structurally related sequence from the CNBr-cleaved fragment CB3 of the alpha 1 chain of collagen type IV, FYFDLR, inhibits endothelial cell adhesion to both collagen types I and IV and laminin 1.

Alanine-scanning mutagenesis of human interleukin-11: identification of regions important for biological activity.

We have identified functionally important regions of human interleukin-11 (hIL-11) by means of alanine-scanning mutagenesis. A total of 61 mutated forms of hIL-11 were produced in E. coli as thioredoxin fusion proteins and tested in a murine T10 plasmacytoma proliferation assay.

Cellulitis owing to Aeromonas hydrophilia: treatment with hyperbaric oxygen.

Aeromonas hydrophilia, a Gram-negative facultative anaerobe, is a rare cause of cellulitis. We review the literature and report a case of Aeromonas hydrophilia cellulitis which failed to respond to the conventional management of surgical debridement and antibiotics. Hyperbaric oxygen therapy was used successfully to control the infection.

Application of linear and nonlinear time series modeling to heart rate dynamics analysis.

The linear autoregressive (AR) model is often used to investigate the pathophysiologic mechanisms controlling heart rate (HR) dynamics. This study implemented parametric models new to this field to determine if a more appropriate HR dynamics modeling structure exists. The linear AR and autoregressive-moving average (ARMA) models, and the nonlinear polynomial autoregressive (PAR) and bilinear (BL) models were fit to instantaneous HR time series obtained from nine subjects in the supine position.

Influence of autoregressive model parameter uncertainty on spectral estimates of heart rate dynamics.

Linear autoregressive (AR) model-based heart rate (HR) spectral analysis has been widely used to study HR dynamics. Owing to system and measurement noise, the parameters of an AR model have intrinsic statistical uncertainty. In this study, we evaluate how this AR parameter uncertainty can translate to uncertainty in HR power spectra.

Early intervention in low-birth-weight premature infants. Results through age 5 years from the Infant Health and Development Program.

Objective: To evaluate the persistence of effects on health and development at age 5 years of the Infant Health and Development Program, an early childhood intervention that was provided to low-birth-weight (LBW) premature infants from neonatal discharge through age 3 years.

Design: Randomized, controlled, multicenter trial, stratified by two LBW groups: lighter (< or = 2000 g) and heavier (2001 to 2500 g).

Setting: Eight socioeconomically heterogeneous clinical sites.

The synthesis of novel HIV-protease inhibitors.

The syntheses, enzyme inhibition and antiviral activity of potent HIV-protease inhibitors containing novel beta-hydroxy ether and thioethers based on the transition state mimetic concept are discussed.

Helicobacter pylori in patients undergoing upper endoscopy in Jamaica.

One hundred and two consecutive patients undergoing upper gastrointestinal endoscopy were tested for H. pylori by a rapid urease test, using antral biopsy specimens. There were 60 men (mean age 54 yrs) and 42 women (mean age 49 yrs).

Structure and orientation of the pore-forming peptide, melittin, in lipid bilayers.

Ten analogues of the 26-residue, bee venom peptide, melittin (H3N(+)-GIGAVLKVLTTGLPALISWIKRKRQQ-CONH2), were synthesized, each with 13C enrichment of a single peptide carbonyl carbon. These peptides were incorporated into bilayers of the diether lipid, ditetradecylphosphatidylcholine, aligned between stacked glass plates. Solid-state 13C nuclear magnetic resonance spectra were obtained as a function of the angle between the bilayer planes and the magnetic field of the spectrometers, and at temperatures above and below the lipid gel-to-liquid crystalline transition temperature, Tc.

Initial experience with the treatment of supracondylar femoral fractures using the supracondylar intramedullary nail: a preliminary report.

Initial experience at a Level I Trauma Center with the use of a retrograde supracondylar intramedullary (IM) nail for the treatment of supracondylar and supracondylar-intercondylar intraarticular fractures of the distal femur is presented. Thirty-eight patients with 41 complex distal femur fractures were treated with this newly developed retrograde IM rod. These included 22 open fractures and 19 closed fractures.

Analysis of heart rate dynamics as a measure of autonomic tone in obstetrical patients undergoing epidural or spinal anesthesia.

Background And Objectives: The purpose of this study is to determine if spectral analysis of beat-to-beat heart rate variability will provide important data on autonomic nervous system function during either spinal or epidural anesthesia that is not apparent from the monitoring of mean heart rate and blood pressure.

Methods: Twelve ASA I patients presenting for elective cesarean delivery (7 epidural and 5 spinal anesthetics) were prospectively selected for study. Control and postblock 10-minute segments of instantaneous heart rates were analyzed for each patient.

Collagen-associated molecules in the cornea: localisation with monoclonal antibodies.

This paper describes the biochemical characteristics and immunostaining properties of four monoclonal antibodies (MAbs) raised to the extracellular matrix of bovine corneal endothelial cells in culture. All four antibodies labelled molecules in frozen sections of bovine cornea. MAb A15 labelled the collagen lamellae of the stroma.

False aneurysm of the medial inferior genicular artery after intramedullary nailing of the tibia.

Although rare, arterial false aneurysm about the knee has been a well-documented complication of many types of surgery. False aneurysms have been reported after such procedures as open meniscectomy, synovectomy, arthroscopy, total knee arthroplasty, and proximal tibial osteosynthesis. Arteries injured in these procedures have included the popliteal artery and the descending, medial superior, medial inferior, lateral superior, and lateral inferior genicular arteries.

Chronic cough due to gastroesophageal reflux. Clinical, diagnostic, and pathogenetic aspects.

Background: Gastroesophageal reflux (GER) is a common cause of chronic cough. Moreover, chronic cough can be the sole presenting manifestation of GER disease (GERD). It has been suggested recently that GER most often causes chronic cough by stimulating the distal esophagus.

Ipsilateral hip and femoral shaft fractures.

Forty-two cases of ipsilateral hip and femoral shaft fractures are reviewed. All patients were treated operatively for both fractures, with the exception of the shaft fracture in one child. Several different methods of fixation were used.

Regulation of PaCO2 during rest and exercise: a modeling study.

A nonlinear mathematical model of the CO2 control system was used to examine a number of issues concerning the regulation of PaCO2 during rest and exercise. To gain insight to the regulatory properties of the respiratory system, the open loop gain (GL) and closed loop sensitivities SI = delta PaCO2/delta PICO2 and SV = delta PaCO2/delta VCO2 were calculated. GL indicates the ability of a control system to regulate the controlled variable, PaCO2 in the model.