Science surrounding the safe use of bioactive ingredients in infant formula: federal comment.

Less than a quarter of U.S. infants meet the federal recommendation for exclusively breastfeeding to 6 months of age, necessitating access to safe and effective infant formula.

A low-cost robotic oculomotor simulator for assessing eye tracking accuracy in health and disease.

Eye tracking accuracy is affected in individuals with vision and oculomotor deficits, impeding our ability to answer important scientific and clinical questions about these disorders. It is difficult to disambiguate decreases in eye movement accuracy and changes in accuracy of the eye tracking itself. We propose the EyeRobot-a low-cost, robotic oculomotor simulator capable of emulating healthy and compromised eye movements to provide ground truth assessment of eye tracker performance, and how different aspects of oculomotor deficits might affect tracking accuracy and performance.

[A novel questionnaire to assess activity in patients after hip arthroplasties].

Background: Until now, the activity of the lower limb could only be exactly measured with expensive electronic pedometers. The aim of this study was to develop a feasible questionnaire to measure the activity of patients after arthroplasty.

Methods: The "Daily Activity Questionnaire" (DAQ) was developed in several steps and the evaluation was carried out in three groups of patients with osteoarthritis of the hip (160 patients and 855 investigated days).

Lateralization of narrow-band noise by blind and sighted listeners.

The effects of varying interaural time delay (ITD) and interaural intensity difference (IID) were measured in normal-hearing sighted and congenitally blind subjects as a function of eleven frequencies and at sound pressure levels of 70 and 90 dB, and at a sensation level of 25 dB (sensation level refers to the pressure level of the sound above its threshold for the individual subject). Using an 'acoustic' pointing paradigm, the subject varied the IID of a 500 Hz narrow-band (100 Hz) noise (the 'pointer') to coincide with the apparent lateral position of a 'target' ITD stimulus. ITDs of 0, +/-200, and +/-400 micros were obtained through total waveform delays of narrow-band noise, including envelope and fine structure.

Multicenter study of surfactant (beractant) use in the treatment of term infants with severe respiratory failure. Survanta in Term Infants Study Group.

Objective: The purpose of this study was to determine whether surfactant (beractant) administration to term newborns in respiratory failure and at risk for requiring extracorporeal membrane oxygenation (ECMO) treatment would significantly reduce the incidence of severe complications through 28 days of age and the need for ECMO.

Study Design: A multicenter (n = 44), randomized, double-blind, placebo-controlled trial was conducted. Infants weighing 2000 gm or more with gestational ages of 36 weeks or greater were stratified by diagnosis (meconium aspiration syndrome, sepsis, or idiopathic persistent pulmonary hypertension of the newborn) and oxygenation index (15 to 22, 23 to 30, 31 to 39) and then randomly assigned to receive four doses of beractant, 100 mg/kg (n = 167), or air placebo (n = 161) before ECMO treatment and four additional doses during ECMO, if ECMO was required.

Surfactant content in children with inflammatory lung disease.

Objective: To determine surfactant profiles of tracheal secretions in mechanically ventilated children with respiratory failure secondary to bacterial pneumonia, viral pneumonitis, adult respiratory distress syndrome (ARDS), and cardiopulmonary bypass.

Design: Prospective, cohort study.

Setting: Tertiary, multidisciplinary, pediatric intensive care unit.

Serial lecithin/sphingomyelin ratios and surfactant/albumin ratios in tracheal aspirates from term infants with respiratory failure receiving extracorporeal membrane oxygenation.

Serial tracheal aspirate samples were obtained for determination of lecithin/sphingomyelin (L/S) ratios from 47 term infants in respiratory failure. Phospholipids were extracted with Folch solution (chloroform:methanol, 2:1 by vol) and analyzed by HPLC with use of silica column and a mobile phase of acetonitrile:methanol:water (48:31:21, by vol). Surfactant/albumin (S/A) ratios were determined with the TDx Fetal Lung Maturity Assay (Abbott Labs).

Surfactant (beractant) therapy for infants with congenital diaphragmatic hernia on ECMO: evidence of persistent surfactant deficiency.

Infants with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO) can have initial lung atelectasis which, in survivors, gradually improves over time. To test the hypothesis that these patients could benefit from surfactant therapy, infants with CDH (born at > 34 weeks' gestation) on ECMO received either four doses of modified bovine lung surfactant extract (beractant) (surfactant group, n = 9) or an equal volume of air (control group, n = 8). Tracheal aspirate surfactant protein-A (SP-A) concentrations were initially low, and then increased over time in both CDH groups (P = .

Improved pulmonary outcome after exogenous surfactant therapy for respiratory failure in term infants requiring extracorporeal membrane oxygenation.

A blinded, randomized, controlled study was designed to test whether multiple-dose surfactant therapy would improve pulmonary outcome in term infants with respiratory failure, resulting in a shortened period of extracorporeal membrane oxygenation (ECMO). Infants > or = 34 weeks of gestational age in severe respiratory failure and receiving ECMO were stratified by diagnosis and then randomly assigned to the treatment or the control group. Four doses of modified bovine lung surfactant extract (beractant) were administered to the surfactant group (n = 28), and an equal volume of air was administered to the control group (n = 28).

Extracorporeal membrane oxygenation therapy in neonates with septic shock.

Neonatal septic shock has significant morbidity and mortality with current therapeutic measures. At Children's National Medical Center, from June 1984 to October 1986, 10 of 100 patients treated with venoarterial extracorporeal membrane oxygenation (ECMO) had a documented diagnosis of septic shock. All of these infants fulfilled criteria consistent with 80% mortality using conventional intensive medical management.

Surfactant protein A concentrations in tracheal aspirate fluid from infants requiring extracorporeal membrane oxygenation.

To understand the lung abnormalities leading to respiratory failure in infants, we measured 35,000-dalton surfactant protein A concentrations in tracheal aspirate fluid collected daily from 25 infants receiving extracorporeal membrane oxygenation (ECMO). Surfactant protein A concentrations were standardized per milligrams of total protein present in the aspirate. Among the 23 survivors with complete data, the surfactant protein A concentration increased significantly with time (p less than 0.

Stunned myocardium in an infant treated with extracorporeal membrane oxygenation.

This report describes a case of postischemic myocardial dysfunction that was successfully treated with ECMO.

Steady-state dopamine clearance in critically ill infants and children.

Little is known about dopamine pharmacokinetics in pediatric patients, especially in critically ill infants and children who often receive treatment with dopamine. Arterial plasma concentrations of dopamine were measured in 27 patients who were hemodynamically stable and received dopamine for at least one hour. The dopamine levels were measured using liquid chromatography with electrochemical detection.

Lung compliance as a measure of lung function in newborns with respiratory failure requiring extracorporeal membrane oxygenation.

Extracorporeal membrane oxygenation (ECMO) can now be used as an alternative mode of therapy for infants 2.0 kg or more with life-threatening respiratory failure. Current criteria for removal from ECMO are limited.

Diffuse pulmonary opacification in infants undergoing extracorporeal membrane oxygenation: clinical and pathologic correlation.

Diffuse pulmonary opacification is commonly seen on chest radiographs from infants with severe respiratory failure treated with extracorporeal membrane oxygenation (ECMO). The chest radiographs and clinical records of 18 such infants were reviewed to determine the correlation among degree of abnormality on chest radiograph (as determined by a radiographic score), clinical severity of disease (as measured by ECMO requirements [ECMO flow rate]), and dynamic lung compliance determinations. Increasing lung compliance and decreasing ECMO flow rates correlated well with decreasing (improving) radiographic score.