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Sample records for neonatal familial evans

  1. Neonatal treatment with capsaicin influences hormonal regulation of blood pressure in adult, water-deprived Long-Evans but not Brattleboro rats.

    PubMed

    Bennett, T; Gardiner, S M

    1986-01-16

    Conscious, adult, water-deprived Brattleboro rats treated neonatally with capsaicin or vehicle showed similar hypotensive responses to sequential inhibition of the renin-angiotensin system (with captopril) and antagonism of ganglionic transmission (with pentolinium). Following a comparable experimental protocol, Long-Evans rats treated neonatally with capsaicin showed a more marked hypotensive response to captopril administration than did vehicle-injected animals. Furthermore, following administration of captopril and pentolinium, the capsaicin-treated animals showed marked impairment of the vasopressin-dependent recovery of blood pressure. These results indicate that the greater hypotensive response to captopril in water-deprived. Long-Evans rats treated neonatally with capsaicin may be due to less effective compensation for inhibition of the renin-angiotensin system when vasopressin release is impaired.

  2. [Familial congenital hypomagnesemia revealed by neonatal convulsions].

    PubMed

    Ndiaye, M; Dehanin, T; Sow, A-D; Sène, M-S; Basse, A-M; Fall, A-L; Seck, L-B; Touré, K; Diop, A-G; Sow, H-D; Ndiaye, M-M

    2013-11-01

    Congenital hypomagnesemia is a rare disease, with an impact on cognitive and neurological development. We report on three familial cases of congenital hypomagnesemia, two boys and one girl who belong to the same consanguineous family. They all presented neonatal seizures and a psychomotor developmental delay. Cerebral computed tomography showed cerebral atrophy and calcifications in one case and magnetic resonance imaging found predominant cerebellar atrophy in the two other cases. All three patients also had hypocalcemia, hyperphosphoremia, and hypomagnesemia. The parathyroid hormone blood level was low in two cases and normal in the third. One 7-month old patient died. The others received a supplementation of calcium and magnesium, which normalized calcemia, phosphatemia but not magnesemia, which remained low despite high doses. They have both developed cognitive and behavioral impairments.

  3. Early neonatal experience of Long-Evans rats results in long-lasting changes in reactivity to a novel environment and morphine-induced sensitization and tolerance.

    PubMed

    Kalinichev, Mikhail; Easterling, Keith W; Holtzman, Stephen G

    2002-10-01

    In Long-Evans rats, daily 3-h separation from the dam during the neonatal period results in enduring alterations in behavioral and neuroendocrine responses to stressors and sensitivity to antinociceptive effects of acute and chronic morphine. We tested whether early neonatal experience alters sensitivity to effects of morphine on locomotor activity. The subjects were adult rats that had one of the following backgrounds: daily separation from the dam on postnatal days 2-14 for either 3 h (maternal separation (MS)) or 15 min (handled control (H)) or no separation from the dam (non-handled control (NH)). After two consecutive days of baseline activity measurements, subjects were tested daily after SC injections of either morphine (10 mg/kg) or saline for seven days and again on day 10. Beginning five days later, saline and 1.0-10 mg/kg of morphine were tested in all animals. On the baseline days, MS animals had higher horizontal and vertical activity than did NH controls, whereas H animals spent more time in the center of the testing chamber. In MS and H animals but not in NH controls, daily injections of morphine produced progressive increases in all locomotor activity measures, indicative of sensitization (horizontal counts, center time) and tolerance (vertical counts). MS animals with a history of morphine treatment had significantly higher horizontal and vertical activity after a saline injection than did their counterparts with a history of saline treatment, indicative of conditioning. They also exhibited greater locomotor sensitization to 1.0 mg/kg of morphine than did H and NH controls. These results provide further evidence that environmental manipulation in the form of maternal separation early in life results in enduring changes in sensitivity to effects of morphine that could reflect altered endogenous opioid systems.

  4. Assessment of family needs in neonatal intensive care units.

    PubMed

    Mundy, Cynthia A

    2010-03-01

    Limited research has been conducted to assess family needs in neonatal intensive care units. Health care providers often make assumptions about what families need, but these assumptions are unfounded and can lead to inappropriate conclusions. When assessed appropriately, family needs can be incorporated into individualized plans of care, enhancing family-centered care. To assess the needs of parents in neonatal intensive care units, we asked the following 3 questions: What are the most and least important needs of families in a level III neonatal intensive care unit? Do parents' needs differ at admission and discharge? Do the needs of mothers and fathers differ? Parents were interviewed by using the Neonatal Intensive Care Unit Family Needs Inventory. Participants rated statements as not important (1), slightly important (2), important (3), very important (4), or not applicable (5). Fifty-two (93%) of the 56 items were rated as important or very important, and parents rated assurance-type needs highest. Parents at admission rated support needs higher than parents at discharge rated those needs. Needs of mothers and fathers did not differ significantly. Identifying the needs of parents in neonatal intensive care units can enhance nursing communication and allow nurses to incorporate parents' needs into families' plans of care. The family needs inventory can help identify those needs and allows the integration of individualized nursing care to fulfill those needs, providing a positive family-centered experience in the unit for patients and their families.

  5. Andreas Rett and benign familial neonatal convulsions revisited.

    PubMed

    Zimprich, F; Ronen, G M; Stögmann, W; Baumgartner, C; Stögmann, E; Rett, B; Pappas, C; Leppert, M; Singh, N; Anderson, V E

    2006-09-12

    In 1964 Andreas Rett published the first account of a family with benign familial neonatal convulsions (BFNC). The authors retraced Rett's family and report that the clinical and genetic features of this original family fit the currently accepted definitions of BFNC. They also consider the career of Dr. Rett, a researcher and social reformer as well as an advocate for the rights of children with developmental disabilities.

  6. Maternal family history of hypertension attenuates neonatal pain response.

    PubMed

    France, Christopher R; Taddio, Anna; Shah, Vibhuti S; Pagé, M Gabrielle; Katz, Joel

    2009-04-01

    Reduced sensitivity to naturally occurring and laboratory pain stimuli has been observed in individuals with hypertension, high-normal blood pressure, and a family history of hypertension. The present study sought to extend these findings by examining the relationship between familial history of hypertension and pain responsivity in neonates. Eighty infants had intramuscular (IM) injections of vitamin K performed in the delivery room within 1h of birth as per institutional practice. Video recordings of the injection procedure were used by trained observers to code infant pain responses using facial grimacing and cry duration. Prior to the birth of the child, the infants' parents each completed a family blood pressure history survey and these responses were used to identify infants with and without a maternal and paternal family history of hypertension. As compared to infants without a maternal family history of hypertension, infants with a maternal family history of hypertension had significantly shorter crying times, F(1,74)=6.96, p=.01, eta(2)=.086, and marginally lower facial grimacing scores, F(1,74)=2.68, p=.10, eta(2)=.035, during vitamin K injection. The presence of attenuated responses to the IM injection in neonates with a maternal family history of hypertension provides important and novel evidence that reduced pain responding in individuals at risk for hypertension is not a learned response style, but rather may arise from prenatal or genetic influences.

  7. [Family participation in premature care in neonatal ICU].

    PubMed

    Gaíva, Maria Aparecida Munhoz; Scochi, Carmen Gracinda Silvan

    2005-01-01

    This study aimed at analyzing the family participation in the premature assistance in a university hospital neonatal ICU. Data were collected from the participant observation. Results showed that despite of the mother's presence in the daily life of their premature children placed in a hospital, family isn't inserted in the work process and mothers are the only ones who take part of the cares. This participation basically happens in the execution of maternity care, especially at the medium risk unity, the mother and premature family are less welcomed and there isn't any partnership between the care team and the family, there aren't team interventions in order to turn premature family in autonomous subject to promote health and life quality to baby's life.

  8. Novel KCNQ3 Mutation in a Large Family with Benign Familial Neonatal Epilepsy: A Rare Cause of Neonatal Seizures

    PubMed Central

    Maljevic, Snezana; Vejzovic, Sabina; Bernhard, Matthias K.; Bertsche, Astrid; Weise, Sebastian; Döcker, Miriam; Lerche, Holger; Lemke, Johannes R.; Merkenschlager, Andreas; Syrbe, Steffen

    2016-01-01

    Benign familial neonatal seizures (BFNS) present a rare familial epilepsy syndrome caused by genetic alterations in the voltage-gated potassium channels Kv7.2 and Kv7.3, encoded by KCNQ2 and KCNQ3. While most BFNS families carry alterations in KCNQ2, mutations in KCNQ3 appear to be less common. Here, we describe a family with 6 individuals presenting with neonatal focal and generalized seizures. Genetic testing revealed a novel KCNQ3 variant, c.835G>T, cosegregating with seizures in 4 tested individuals. This variant results in a substitution of the highly conserved amino acid valine localized within the pore-forming transmembrane segment S5 (p.V279F). Functional investigations in Xenopus laevis oocytes revealed a loss of function, which supports p.V279F as a pathogenic mutation. When p.V279F was coexpressed with the wild-type (WT) Kv7.2 subunits, the resulting potassium currents were about 10-fold reduced compared to the WT Kv7.3 and Kv7.2 coexpression. Genotype-phenotype correlation shows an incomplete penetrance of p.V279F. Response to antiepileptic treatment was variable, but evaluation of treatment response remained challenging due to the self-limiting character of the disease. The identification of the pathogenic variant helped to avoid unnecessary investigations in affected family members and allowed guided therapy. PMID:27781029

  9. Novel KCNQ3 Mutation in a Large Family with Benign Familial Neonatal Epilepsy: A Rare Cause of Neonatal Seizures.

    PubMed

    Maljevic, Snezana; Vejzovic, Sabina; Bernhard, Matthias K; Bertsche, Astrid; Weise, Sebastian; Döcker, Miriam; Lerche, Holger; Lemke, Johannes R; Merkenschlager, Andreas; Syrbe, Steffen

    2016-09-01

    Benign familial neonatal seizures (BFNS) present a rare familial epilepsy syndrome caused by genetic alterations in the voltage-gated potassium channels Kv7.2 and Kv7.3, encoded by KCNQ2 and KCNQ3. While most BFNS families carry alterations in KCNQ2, mutations in KCNQ3 appear to be less common. Here, we describe a family with 6 individuals presenting with neonatal focal and generalized seizures. Genetic testing revealed a novel KCNQ3 variant, c.835G>T, cosegregating with seizures in 4 tested individuals. This variant results in a substitution of the highly conserved amino acid valine localized within the pore-forming transmembrane segment S5 (p.V279F). Functional investigations in Xenopus laevis oocytes revealed a loss of function, which supports p.V279F as a pathogenic mutation. When p.V279F was coexpressed with the wild-type (WT) Kv7.2 subunits, the resulting potassium currents were about 10-fold reduced compared to the WT Kv7.3 and Kv7.2 coexpression. Genotype-phenotype correlation shows an incomplete penetrance of p.V279F. Response to antiepileptic treatment was variable, but evaluation of treatment response remained challenging due to the self-limiting character of the disease. The identification of the pathogenic variant helped to avoid unnecessary investigations in affected family members and allowed guided therapy.

  10. Genetic recombination at the human RH locus: A family study of the red-cell Evans phenotype reveals a transfer of exons 2-6 from the RHD to the RHCE gene

    SciTech Connect

    Huang, C.H.; Chen, Y.; Reid, M.; Ghosh, S.

    1996-10-01

    The human RH locus appears to consist of two structural genes, D and CE, which map on the short arm p34-36 of chromosome 1 and specify a most complex system of blood-group genetic polymorphisms. Here we describe a family study of the Evans (also known as {open_quotes}D..{open_quotes}) phenotype, a codominant trait associated with both qualitative and quantitative changes in D-antigen expression. A cataract-causing mutation was also inherited in this family and was apparently cotransmitted with Evans, suggesting a chromosomal linkage of these two otherwise unrelated traits. Southern blot analysis and allele-specific PCR showed the linkage of Evans with a SphI RFLP marker and the presence of a hybrid gene in the RH locus. To delineate the pattern of gene expression, the composition and structure of Rh-polypeptide transcripts were characterized by reverse transcriptase-PCR and nucleotide sequencing. This resulted in the identification of a novel Rh transcript expressed only in the Evans-positive erythroid cells. Sequence analysis showed that the transcript maintained a normal open reading frame but occurred as a CE-D-CE composite in which exons 2-6 of the CE gene were replaced by the homologous counterpart of the D gene. This hybrid gene was predicted to encode a CE-D-CE fusion protein whose surface expression correlates with the Evans phenotype. The mode and consequence of such a recombination event suggest the occurrence, in the RH locus, of a segmental DNA transfer via the mechanism of gene conversion. 31 refs., 6 figs., 1 tab.

  11. Family Conferences in the Neonatal ICU: Observation of Communication Dynamics and Contributions.

    PubMed

    Boss, Renee D; Donohue, Pamela K; Larson, Susan M; Arnold, Robert M; Roter, Debra L

    2016-03-01

    Clinicians in the neonatal ICU must engage in clear and compassionate communication with families. Empirical, observational studies of neonatal ICU family conferences are needed to develop counseling best practices and to train clinicians in key communication skills. We devised a pilot study to record and analyze how interdisciplinary neonatal ICU clinicians and parents navigate difficult conversations during neonatal ICU family conferences. We prospectively identified and audiotaped a convenience sample of neonatal ICU family conferences about "difficult news." Conversations were analyzed using the Roter interaction analysis system, a quantitative tool for assessing content and quality of patient-provider communication. An urban academic children's medical center with a 45-bed level IV neonatal ICU. Neonatal ICU parents and clinicians. None. We analyzed 19 family conferences that included 31 family members and 23 clinicians. The child's mother was included in all conferences, and a second parent, usually the father, was present in 13 conferences. All but one conference included multiple medical team members. On average, physicians contributed 65% of all dialogue, regardless of who else was present. Over half (56%) of this dialogue involved giving medical information; under 5% of clinician dialogue involved asking questions of the family, and families rarely (5% of dialogue) asked questions. Conversations were longer with the presence of nonphysician clinicians, but this did not increase the amount of dialogue about psychosocial information or increase parent dialogue. We collected a novel repository of audio-recorded neonatal ICU family meetings that offers insights into discussion content and process. These meetings were heavily focused on biomedical information even when interdisciplinary clinicians were present. Clinicians always talked more than parents, and no one asked many questions. Maximizing the participation of interdisciplinary clinicians in neonatal

  12. Mexican Immigrant Families' Beliefs and Goals for Their Infants in the Neonatal Intensive Care Unit.

    ERIC Educational Resources Information Center

    Denney, Maria K.; Singer, George H. S.; Singer, Joanne; Brenner, Mary E.; Okamoto, Yukari; Fredeen, Rosy M.

    2001-01-01

    A study of six Mexican immigrant families with infants in the neonatal intensive care unit found they had distinct caregiving beliefs and certain hospital practices were different from their beliefs and customs. Communication and cultural barriers were identified family stressors. Extended family were described as a valuable source of support.…

  13. Family-Centered Services in The Neonatal Intensive Care Unit: A Review of Research.

    ERIC Educational Resources Information Center

    O'Brien, Marion; Dale, Deborah

    1994-01-01

    This paper reviews evaluations of family-centered intervention programs conducted in neonatal intensive care units. Of 10 studies identified, 3 focused on intervention to benefit the family system; 6 involved parents, but the primary focus was the infant; and 1 study combined the 2 approaches. All the studies had substantial limitations.…

  14. Cardiovascular Ultrasound of Neonatal Long Evans Rats ...

    EPA Pesticide Factsheets

    This abstract describes the use of a relatively new technology, cardiovascular ultrasound (echocardiography) for evaluating developmental toxicity affecting heart development. The abstract describes the effects of two known cardiac teratogens, trichloroacetic acid and dimethadione, and their effects as determined by echocardiography. This abstract describes the use and development of a relatively new technology, cardiovascular ultrasound (echocardiography) for evaluating developmental toxicity affecting heart development.

  15. Exacerbation of benign familial neonatal epilepsy induced by massive doses of phenobarbital and midazolam.

    PubMed

    Maeda, Tomoki; Shimizu, Miki; Sekiguchi, Kazuhito; Ishii, Atsushi; Ihara, Yukiko; Hirose, Shinichi; Izumi, Tatsuro

    2014-08-01

    Barbiturates and benzodiazepines are the first-line anticonvulsants for neonatal seizures. However, in immature brains, those drugs may lead to paradoxical neuronal excitation. A patient with benign familial neonatal epilepsy developed epileptic encephalopathy after massive doses of phenobarbital that were followed by a continuous infusion of midazolam on postnatal day 3. Electroencephalography revealed rhythmic delta activity in clusters with migrating epileptic foci. After discontinuation of both drugs, the patient's consciousness promptly improved and her electroencephalography normalized on postnatal day 5. This baby developed persistent electroencephalographic seizures due to massive doses of phenobarbital and midazolam. Clinicians should be aware of this anticonvulsant-induced paradoxical neuronal excitation and the uncoupling phenomenon, especially in individuals with benign familial neonatal epilepsy, who have low seizure thresholds. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Postdischarge Service Use by Families of Neonatal Intensive Care Unit Graduates.

    ERIC Educational Resources Information Center

    Tien, Chia-Ling; Peterson, Carla A.; Shelley, Mack C., II

    2002-01-01

    A study examined patterns and predictors of service use by 85 families of Neonatal Intensive Care Unit (NICU) graduates, specifically premature infants. Enabling variables (NICU contacts and follow-up services) and parents' perceptions of children's problems were major predictors of service use. No demographic characteristics predicted service…

  17. Measurement of Family-centered care perception and parental stress in a neonatal unit 1

    PubMed Central

    Balbino, Flávia Simphronio; Balieiro, Maria Magda Ferreira Gomes; Mandetta, Myriam Aparecida

    2016-01-01

    ABSTRACT Objective: to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. Method: a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. Results: there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). Conclusion: the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress. PMID:27508921

  18. A short form of the neonatal intensive care unit family needs inventory.

    PubMed

    Alves, Elisabete; Severo, Milton; Amorim, Mariana; Grande, Catarina; Silva, Susana

    2016-01-01

    The identification of parental needs in Neonatal Intensive Care Units is essential to design and implement family-centered care. This article aims to validate the Neonatal Intensive Care Units Family Needs Inventory for the Portuguese population, and to propose a Short Form. A linguistic adaptation of the Neonatal Intensive Care Units Family Needs Inventory, a self-report scale with 56-items, was performed. The instrument was administered to 211 parents of infants hospitalized in all level III Neonatal Intensive Care Units in the North of Portugal, 15-22 days after admission (July of 2013-June of 2014). The number of items needed to achieve reliability close to 0.8 was calculated using by the Spearman-Brown formula. The global goodness of fit of the scale was evaluated using the comparative fit index. Construct validity was assessed through association of each dimension score with socio-demographic and obstetric characteristics. Exploratory factor analysis revealed two dimensions, one focused on parents' needs and another on the infant's needs. To compose the Short Form Inventory, items with ceiling effect were eliminated and 22 items were submitted to confirmatory analysis, which supported the existence of two dimensions (CFI=0.925). The Short Form showed a high degree of reliability (alpha≥0.76). Less educated and older parents more frequently attributed a significantly higher importance to parent-centered needs, while parents of multiples revealed a tendency to value infant-centered needs. The Short Form of the Neonatal Intensive Care Units Family Needs Inventory is a brief, simple, and valid instrument with a high degree of reliability. Further studies are needed to explore associations with practices of family-centered care. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  19. Regulation of neonatal and adult mammalian heart regeneration by the miR-15 family

    PubMed Central

    Porrello, Enzo R.; Mahmoud, Ahmed I.; Simpson, Emma; Johnson, Brett A.; Grinsfelder, David; Canseco, Diana; Mammen, Pradeep P.; Rothermel, Beverly A.; Olson, Eric N.; Sadek, Hesham A.

    2013-01-01

    We recently identified a brief time period during postnatal development when the mammalian heart retains significant regenerative potential after amputation of the ventricular apex. However, one major unresolved question is whether the neonatal mouse heart can also regenerate in response to myocardial ischemia, the most common antecedent of heart failure in humans. Here, we induced ischemic myocardial infarction (MI) in 1-d-old mice and found that this results in extensive myocardial necrosis and systolic dysfunction. Remarkably, the neonatal heart mounted a robust regenerative response, through proliferation of preexisting cardiomyocytes, resulting in full functional recovery within 21 d. Moreover, we show that the miR-15 family of microRNAs modulates neonatal heart regeneration through inhibition of postnatal cardiomyocyte proliferation. Finally, we demonstrate that inhibition of the miR-15 family from an early postnatal age until adulthood increases myocyte proliferation in the adult heart and improves left ventricular systolic function after adult MI. We conclude that the neonatal mammalian heart can regenerate after myocardial infarction through proliferation of preexisting cardiomyocytes and that the miR-15 family contributes to postnatal loss of cardiac regenerative capacity. PMID:23248315

  20. [Individual neonatal end-of-life care and family-centred bereavement support].

    PubMed

    Garten, L; von der Hude, K; Rösner, B; Klapp, C; Bührer, C

    2013-06-01

    Neonatal end-of-life care and family-centred bereavement support in perinatal medicine are a multiprofessional challenge directed to the dying newborn and the parents as well as to the care-givers. Clinical experience shows that many aspects of individual neonatal end-of-life care and family-centred bereavement support are not well known to the health-care providers. This is especially true for a standardised quality management and the components of bereavement support offered to parents. An interdisciplinary concept for an individual neonatal end-of-life care and famlily-centred bereavement support has been developed at the Center of Perinatal Medicine at the Charité, Berlin. The concept aims for two main aspects: (1) meeting the individual medical, psychological, emotional and spiritual needs of the dying newborn, the parents and family, and (2) facilitating standardised and process-orientated preparation, evaluation and reflexion of every case of end-of-life care. In this article some recommendations for implementing a basic care concept for families and their dying newborns are presented.

  1. Alice C. Evans: breaking barriers.

    PubMed Central

    Colwell, R. R.

    1999-01-01

    Despite severe and persistent criticism of her research, Alice Evans persevered in her pioneering work on the bacterial contamination of milk, identifying the organism that caused undulant fever and demonstrating that drinking unpasteurized cow's milk could transmit the disease, undulant fever, to humans. The opprobrium that Alice Evans endured was unrelenting, even after her election as the first President of the Society of American Bacteriologists, (now the American Society for Microbiology), but she remained undeterred, a true heroine of American microbiology and a magnificent public health worker. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:11049166

  2. Recreation conflicts on Mt. Evans

    Treesearch

    Jerry J. Vaske; Karin Wittmann; Susan Laidlaw; Maureen P. Donnelly

    1995-01-01

    This study examines recreation conflict at Mt. Evans, Colorado; a high visibility area that attracts both hunters and non-hunters. Two types of conflict were distinguished: goal interference and conflict of values. Data were obtained from a series of on-site and mailed surveys. For hunting related events (e.g. seeing an animal being shot, hearing...

  3. Quirks of dye nomenclature. 1. Evans blue.

    PubMed

    Cooksey, C J

    2014-02-01

    The history, origin, identity, chemistry and use of Evans blue dye are described along with the first application to staining by Herbert McLean Evans in 1914. In the 1930s, the dye was marketed under the name, Evans blue dye, which was profoundly more acceptable than the ponderous chemical name.

  4. Impact of the design of neonatal intensive care units on neonates, staff, and families: a systematic literature review.

    PubMed

    Shahheidari, Marzieh; Homer, Caroline

    2012-01-01

    Newborn intensive care is for critically ill newborns requiring constant and continuous care and supervision. The survival rates of critically ill infants and hospitalization in neonatal intensive care units (NICUs) have improved over the past 2 decades because of technological advances in neonatology. The design of NICUs may also have implications for the health of babies, parents, and staff. It is important therefore to articulate the design features of NICU that are associated with improved outcomes. The aim of this study was to explore the main features of the NICU design and to determine the advantages and limitations of the designs in terms of outcomes for babies, parents, and staff, predominately nurses. A systematic review of English-language, peer-reviewed articles was conducted for a period of 10 years, up to January 2011. Four online library databases and a number of relevant professional Web sites were searched using key words. There were 2 main designs of NICUs: open bay and single-family room. The open-bay environment develops communication and interaction with medical staff and nurses and has the ability to monitor multiple infants simultaneously. The single-family rooms were deemed superior for patient care and parent satisfaction. Key factors associated with improved outcomes included increased privacy, increased parental involvement in patient care, assistance with infection control, noise control, improved sleep, decreased length of hospital stay, and reduced rehospitalization. The design of NICUs has implications for babies, parents, and staff. An understanding of the positive design features needs to be considered by health service planners, managers, and those who design such specialized units.

  5. Obituary: David Stanley Evans, 1916-2004

    NASA Astrophysics Data System (ADS)

    Bash, Frank N.

    2005-12-01

    headquartered in Cape Town, South Africa. David had designed and built a Newtonian spectrograph for the 74-inch Radcliffe Telescope with which he measured the first southern galaxy redshifts. David and his family spent 1965-66 in Austin, Texas, where he was a National Science Foundation Senior Visiting Scientist at the University of Texas and McDonald Observatory. They moved permanently to Austin in 1968 and David became a Professor of Astronomy and Associate Director of McDonald Observatory at the University of Texas at Austin. At McDonald Observatory, R. E. Nather had devised a high-speed photometer capable of measuring millisecond time-scale changes in brightness and with Brian Warner, he invented "high-speed astronomy". This instrument caused Evans to revive his occultation program and, over the next twenty years, he produced the major part of the angular diameters of late-type stars with his students and collaborators. In addition, David and collaborators used the extensive collections of the University of Texas to write "Herschel at the Cape". David was also involved in observing the occultation of ? Sco by Jupiter in 1972 and in observing, during a solar eclipse in 1973, the gravitational deflections in the positions of stars whose light passes near to the Sun. The eclipse was observed from Mauritania, and the observations confirmed Einstein's prediction again. David Evans and his students studied late-type stars that have large star-spots and others that flare. In addition, they studied stars whose lunar occultation observations had revealed them to be double or even more than two stars. David Evans's major scientific contribution was an application of his stellar angular diameters to deduce the surface brightness of stars with the result that with suitable color indices one could use photometry to deduce the angular diameter of stars. This is applicable to stars which can never be occulted by the Moon, and its application to Cepheid variable stars has yielded their

  6. Perinatal, neonatal, and family social factors predicting poor school outcome of low-birth-weight survivors: an integrative review.

    PubMed

    Zhang, Jun; Holditch-Davis, Diane L; Darcy-Mahoney, Ashley

    2015-02-01

    To examine the relationship of perinatal factors, neonatal factors, and family characteristics with school outcomes of low-birth-weight (LBW) children. An integrative review of the literature was performed using electronic databases focusing on key words, including school outcome, school performance, educational outcome, academic outcome/academic achievement, and LBW. The in utero or neonatal risk factors for poor school outcome included in this review were perinatal brain injury, brain structural abnormality, motor deficits, and neonatal conditions. Social risk factors found to contribute to poorer school outcomes were family structure, family stability, parental education, poverty, male sex, nonwhite race, and acculturation level. Long-term school outcomes of LBW children are influenced by a number of factors related to the characteristics of both children and their families. These factors need to be considered when designing preventive interventions.

  7. A family-centered "visitation" policy in the neonatal intensive care unit that welcomes parents as partners.

    PubMed

    Griffin, Terry

    2013-01-01

    Parents are important partners in the neonatal intensive care unit, collaborating with staff in caregiving and decision making for their infants. These essential and mutually beneficial partnerships between families and staff are the cornerstone of family-centered care and require that parents are welcomed to be with their baby at any time. This concept is not new and, yet, many neonatal intensive care units continue to have "visitation" policies that restrict parent's access to their infants, failing to recognize parents as partners. Changing the "visitation" policy is part of a welcoming approach in the context of family-centered care. Neonatal intensive care unit nurses may be accustomed to a more strict policy, needing communication tools and strategies to collaborate with parents and implement a family-centered "visitation" or welcoming policy.

  8. Family Conferences in the Neonatal Intensive Care Unit: Observation of Communication Dynamics and Contributions

    PubMed Central

    Boss, Renee D.; Donohue, Pamela K.; Larson, Susan M.; Arnold, Robert M.; Roter, Debra L.

    2015-01-01

    Objective Clinicians in the neonatal intensive care unit (NICU) must engage in clear and compassionate communication with families. Empirical, observational studies of NICU family conferences are needed to develop counseling best practices and to train clinicians in key communication skills. We devised a pilot study to record and analyze how interdisciplinary NICU clinicians and parents navigate difficult conversations during NICU family conferences. Design We prospectively identified and audiotaped a convenience sample of NICU family conferences about “difficult news.” Conversations were analyzed using the Roter Interaction Analysis System (RIAS), a quantitative tool for assessing content and quality of patient-provider communication. Setting An urban academic children’s medical center with a 45-bed level IV NICU. Participants NICU parents and clinicians. Measurements and Main Results We analyzed 19 family conferences that included 31 family members and 23 clinicians. The child’s mother was included in all conferences and a second parent, usually the father, was present in 13. All but one conference included multiple medical team members. On average, physicians contributed 65% of all dialogue, regardless of who else was present. Over half (56%) of this dialogue involved giving medical information; under 5% of clinician dialogue involved asked questions of the family, and families rarely (5% of dialogue) asked questions. Conversations were longer with the presence of non-physician clinicians, but this did not increase the amount of dialogue about psychosocial information or increase parent dialogue. Conclusions We collected a novel repository of audiorecorded NICU family meetings that offers insights into discussion content and process. These meetings were heavily focused on biomedical information even when interdisciplinary clinicians were present. Clinicians always talked more than parents, and no one asked many questions. Maximizing the participation of

  9. The Obstacles against Nurse-Family Communication in Family-Centered Care in Neonatal Intensive Care Unit: a Qualitative Study.

    PubMed

    Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

    2015-01-01

    Communication is one of the key principles in Family-Centered Care (FCC). Studies have shown some drawbacks in communication between families and nurses. Therefore, the present study aimed to recognize the obstacles against nurse-family communication in FCC in Neonatal Intensive Care Unit (NICU). This qualitative study was conducted on 8 staff nurses in 2 NICUs affiliated to Shiraz University of Medical Sciences selected through purposive sampling. The data were collected using 8 deep semi-structured interviews and 3 observations. Then, they were analyzed through inductive content analysis. Data analysis resulted in identification of 3 main categories and 7 subcategories. The first category was organizational factors with 2 subcategories of educational domain (inadequate education, lack of a system for nursing student selection, and poor professionalization) and clinical domain (difficult working conditions, lack of an efficient system for ongoing education and evaluation, and authoritarian management). The second category was familial factors with socio-cultural, psychological, and economic subcategories. The last category was the factors related to nurses with socio-cultural and psycho-physical subcategories. Identification of the obstacles against nurse-family communication helps managers of healthcare systems to plan and eliminate the challenges of effective communication. Besides, elimination of these factors leads to appropriate strategies in NICUs for effective application of FCC.

  10. Training in Family-Focused Developmental Care: Bridging the Gap between Traditional and Family-Centered Care in a Neonatal Intensive Care Unit.

    ERIC Educational Resources Information Center

    Walburn, Kathleen S.; Balsillie, Lois J.; Heermann, Judith A.

    1997-01-01

    An educational program developed to prepare health professionals in a neonatal intensive care unit to initiate family-focused developmental care (FFDC) is described. The program was designed to support families with preterm infants. Findings suggest that the program was cost-efficient, prepared nurses to efficiently initiate FFDC, and improved…

  11. Neonatal intensive care and late preterm infants: health and family functioning at three years.

    PubMed

    McGowan, Jennifer E; Alderdice, Fiona A; Boylan, Jackie; Holmes, Valerie A; Jenkins, John; Craig, Stanley; Perra, Oliver; Johnston, Linda

    2014-04-01

    Late preterm infants (LPIs), born at 34+0 to 36+6 weeks of gestation contribute a significant proportion of all neonatal intensive care (NIC) admissions and are regarded as being at risk of adverse outcomes compared to term-born infants. To explore the health outcomes and family functioning of LPIs who required neonatal intensive care, at three years of age. This cohort study included 225 children born late preterm, between 1 January and 31 December 2006 in Northern Ireland. Children admitted for NIC (study group, n=103) were compared with children who did not require NIC or who required special care only for up to three days (comparison group, n=122). Health outcomes were measured using the Health Status Questionnaire, health service usage by parent report and family functioning using the PedsQL™ Family Impact Module. LPIs who required NIC revealed similar health outcomes at three years in comparison to those who did not. Despite this, more parents of LPIs who required NIC reported visiting their GP and medical specialists during their child's third year of life. Differences in family functioning were also observed with mothers of LPIs who required NIC reporting, significantly lower levels of social and physical functioning, increased difficulties with communication and increased levels of worry. LPIs were observed to have similar health outcomes at three years of age regardless of NIC requirement. The increase in GP and medical specialist visits and family functioning difficulties observed among those infants who required NIC merits further investigation. Copyright © 2014. Published by Elsevier Ireland Ltd.

  12. Evans function and Fredholm determinants

    PubMed Central

    Karambal, Issa; Malham, Simon J. A.

    2015-01-01

    We explore the relationship between the Evans function, transmission coefficient and Fredholm determinant for systems of first-order linear differential operators on the real line. The applications we have in mind include linear stability problems associated with travelling wave solutions to nonlinear partial differential equations, for example reaction–diffusion or solitary wave equations. The Evans function and transmission coefficient, which are both finite determinants, are natural tools for both analytic and numerical determination of eigenvalues of such linear operators. However, inverting the eigenvalue problem by the free-state operator generates a natural linear integral eigenvalue problem whose solvability is determined through the corresponding infinite Fredholm determinant. The relationship between all three determinants has received a lot of recent attention. We focus on the case when the underlying Fredholm operator is a trace class perturbation of the identity. Our new results include (i) clarification of the sense in which the Evans function and transmission coefficient are equivalent and (ii) proof of the equivalence of the transmission coefficient and Fredholm determinant, in particular in the case of distinct far fields. PMID:25663806

  13. The Growing Burden of Neonatal Opiate Exposure on Children and Family Services in Massachusetts.

    PubMed

    França, Urbano L; Mustafa, Shaheer; McManus, Michael L

    2016-02-01

    Increasing opiate use among women of reproductive age has led to a rise in adverse pregnancy outcomes, including neonatal abstinence syndrome (NAS). Recent studies have documented the increased incidence of NAS, but subsequent impact on the chain of organizations within the social service system remains unexplored. In this article, we begin to estimate the reach of this issue by assessing the labor costs of caring for NAS infants within the Massachusetts Department of Children and Families (MA DCF). Based on a process map of services, we modeled social service hours using encounter-level hospital data as inputs. In this manner, we estimate that MA DCF professionals now devote more than 10,000 hours per month to this single problem. As opiate addiction increases across America, substantial additional investment in social service providers, foster care, Early Intervention Programs, and other family services will be required.

  14. Genetic heterogeneity in benign familial neonatal convulsions: Identification of a new locus on chromosome 8q

    SciTech Connect

    Lewis, T.B.; Leach, R.J.; O'Connell, P.; Ryan, S.G. ); Ward, K. )

    1993-09-01

    The syndrome of benign familial neonatal convulsions (BFNC) is a rare autosomal dominant disorder characterized by unprovoked seizures in the first weeks of life. One locus for BFNC has been mapped to chromosome 20 in several pedigrees, but the authors have excluded linkage to chromosome 20 in one large kindred. In order to identify this novel BFNC locus, dinucleotide repeat markers distributed throughout the genome were used to screen this family. Maximum pairwise LOD scores of 4.43 were obtained with markers D8S284 and D8S256 on chromosome 8q. Multipoint analysis placed the BFNC locus in the interval spanned by D8S198-D8S274. This study establishes the presence of a new BFNC locus and confirms genetic heterogeneity of this disorder. 26 refs., 3 figs., 1 tab.

  15. Neonatal Hearing Screening in primary health care and family health care.

    PubMed

    Sabbag, José Carlos; Lacerda, Adriana Bender Moreira de

    2017-08-10

    The Universal Newborn Hearing Screening (UNHS) looks for early diagnosis and rehabilitation of newborns at risk or not of hearing impairment. The purpose is analyze the flow of Universal Newborn Hearing Screening in the family health care strategy unit through the tracking and monitoring of children. This is a quantitative and retrospective study. The trace begins with the third copy of the Live Newborn Declaration, filled in at the maternity ward. An interview with parents and guardians was made by a community agent at the Health Unit or at the home of the newborn. Monitoring was conducted by live birth declaration and the information collected by the interviewer from maternal and child health booklet and the follow-up at high complexity services. The sample was made up of 50 neonates. 52% were between 30 and 89 days and 54% were male. 12% of newborns presented a risk factor for hearing loss and the neonatal screening was performed in 86% of cases. Hearing health measures show integrality in hearing impairment care at the basic health unit to high complexity hospital. The flow of care for newborn hearing screening is in agreement with the child health care guidelines in Curitiba, however, it is not yet universal. In conclusion, the participation of the family health strategy unit in the tracking and monitoring of children submitted to the Universal newborn hearing screening program is feasible and recommended.

  16. Measurement of Family-centered care perception and parental stress in a neonatal unit.

    PubMed

    Balbino, Flávia Simphronio; Balieiro, Maria Magda Ferreira Gomes; Mandetta, Myriam Aparecida

    2016-08-08

    to evaluate the effects of the implementation of the Patient and Family-Centered Care Model on parents and healthcare perceptions and parental stress. a quasi-experimental study developed in a neonatal unit of a university hospital in the municipality of São Paulo, Brazil, with the implementation of this model of care. Data collection were performed by two sample groups, one using non-equivalent groups of parents, and another using equivalent groups of healthcare professionals. The instruments Perceptions of Family-Centered Care-Parent Brazilian Version, Perceptions of Family-Centered Care-Staff Brazilian Version and Parental Stress Scale: Neonatal Intensive Care Unit, were applied to 132 parents of newborns hospitalized and to 57 professionals. there was a statistically significant improvement in the perceptions of the parents in most items assessed (p ≤0,05) and for the staff in relation to the family welcome in the neonatal unit (p = 0.041) and to the comprehension of the family's experience with the infant´s hospitalization (p = 0,050). There was a reduction in the average scores of parental stress, with a greater decrease in the Alteration in Parental Role from 4,2 to 3,8 (p = 0,048). the interventions improved the perceptions of parents and healthcare team related to patient and family-centered care and contributed to reducing parental stress. avaliar os efeitos da implementação do Modelo do Cuidado Centrado no Paciente e Família na percepção de pais e profissionais de saúde e no estresse parental. Estudo quase experimental com grupos não equivalentes para avaliação dos efeitos da intervenção na percepção de pais; e com grupos equivalentes para a avaliação na percepção de profissionais de saúde, desenvolvido na unidade neonatal de um hospital universitário do município de São Paulo. Os instrumentos, Percepção do Cuidado Centrado na Família- Pais versão brasileira, Percepção do Cuidado Centrado na Família- Equipe vers

  17. Effects of single-family rooms on nurse-parent and nurse-infant interaction in neonatal intensive care unit.

    PubMed

    Toivonen, Mirka; Lehtonen, Liisa; Löyttyniemi, Eliisa; Axelin, Anna

    Single-family rooms in neonatal intensive care unit can provide longer interaction between family and staff. On the other hand, separation in private rooms has been shown detrimental to child development if parents are not present. To examine the effects of single-family rooms on nurse-family, nurse-parent and nurse-infant interaction time in neonatal intensive care unit. A quantitative, comparative, observational study was conducted before and after a move to a neonatal intensive care unit with single-family rooms. A total of 194 observation hours were conducted before the move and 194h after the move. The differences were analyzed using a hierarchical linear mixed model. Nurses working in one neonatal intensive care unit were recruited to study. The duration and number of nurse-parent and nurse-infant interaction episodes were recorded. The nurse-family and the nurse-parent interaction were longer in the unit with single-family rooms compared with the unit before the move (mean 261 vs. 138min per shift, p<0.0001 and 117 vs. 35, p=0.001, respectively). The duration of the nurse-infant interaction did not change after the move. The frequency of the nurse-parent or the nurse-infant interactions did not change between the time periods. Neonatal intensive care unit with single-family rooms supported an increase in nurse-parent interaction time. Importantly, nurse-infant interaction time did not decrease. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. A Qualitative Study of Family Experience With Hospitalization for Neonatal Abstinence Syndrome.

    PubMed

    Atwood, Emily C; Sollender, Grace; Hsu, Erica; Arsnow, Christine; Flanagan, Victoria; Celenza, Joanna; Whalen, Bonny; Holmes, Alison V

    2016-10-01

    Although the incidence of neonatal abstinence syndrome (NAS) in the United States quintupled between 2000 and 2012, little is known about the family perspective of the hospital stay. We interviewed families to understand their experiences during the newborn hospitalization for NAS and to improve family-centered care. A multidisciplinary team from 3 hospital units composed open-ended interview questions based on a literature review, clinical experience, and an internal iterative process. Trained investigators conducted semi-structured interviews with 20 families of newborns with NAS at hospital discharge. Interviews were recorded and transcribed verbatim. Two investigators independently analyzed each transcript, identified themes via an inductive qualitative approach, and reached a consensus on each code. The research team sorted the themes into broader domains through an iterative process that required consensus of 4 team members. Five domains of family experience were identified: parents' desire for education about the course and treatment of NAS; parents valuing their role in the care team; quality of interactions with staff (supportive versus judgmental) and communication regarding clinical course; transfers between units and inconsistencies among providers; and external factors such as addiction recovery and economic limitations. Families face many challenges during newborn hospitalization for NAS. Addressing parental needs through improved perinatal education, increased involvement in the care team, consistent care and communication, and minimized transitions in care could improve the NAS hospital experience. The results of this qualitative study may allow for improvements in family-centered care of infants with NAS. Copyright © 2016 by the American Academy of Pediatrics.

  19. Rallying the Troops: How Sharing Knowledge With Grandparents Supports the Family of the Preterm Infant in Neonatal Intensive Care Unit.

    PubMed

    Brødsgaard, Anne; Helth, Theresa; Andersen, Bente Lund; Petersen, Mette

    2017-06-01

    Research concludes that there is a need for educational programs for grandmothers, as well as networking opportunities; educational programs for other extended family members have long been sought by parents, relatives, and nurses in neonatal intensive care unit. To describe the effect of having premature infants' extended families participating in family-centered care (FCC) groups in the neonatal intensive care unit. An intervention based on dialogue, including topics as own reactions, general knowledge about the premature infants, parenthood, and how the extended families can support the new families during hospitalization and after discharge. A qualitative content analysis of 2 focus group interviews involving 16 purposefully sampled extended family members, who had participated in 1½ hours of FCC group interventions. The overall theme was: Accepting the individuality of the infant and providing the family with realistic expectations for the future. This theme emerged during the analysis of 4 categories: knowledge sharing, same basis for understanding, access to the immediate family, and competent supporting role. The interrelationship between the categories also emerged, surprisingly, during the analysis. Extended family members should be recognized as an essential part of the new family's life from the time of the premature infant's admission to neonatal intensive care unit. Family-centered care group interventions should be integrated into ward practice and policy. The study reinforces the need for further research, utilizing both qualitative and quantitative methods, into age and ethnicity aspects of FCC group interventions. There is also a need to compare the new parents' perceived level of stress and support from the FCC group intervention in relation to participating and nonparticipating extended families.

  20. A comparison of parent satisfaction in an open-bay and single-family room neonatal intensive care unit.

    PubMed

    Stevens, Dennis C; Helseth, Carol C; Khan, M Akram; Munson, David P; Reid, E J

    2011-01-01

    The purpose of this research was to test the hypothesis that parental satisfaction with neonatal intensive care is greater in a single-family room facility as compared with a conventional open-bay neonatal intensive care unit (NICU). This investigation was a prospective cohort study comparing satisfaction survey results for parents who responded to a commercially available parent NICU satisfaction survey following the provision of NICU care in open-bay and single-family room facilities. A subset of 16 items indicative of family-centered care was also computed and compared for these two NICU facilities. Parents whose babies received care in the single-family room facility expressed significantly improved survey responses in regard to the NICU environment, overall assessment of care, and total survey score than did parents of neonates in the open-bay facility. With the exception of the section on nursing in which scores in both facilities were high, nonsignificant improvement in median scores for the sections on delivery, physicians, discharge planning, and personal issues were noted. The total median item score for family-centered care was significantly greater in the single-family room than the open-bay facility. Parental satisfaction with care in the single-family room NICU was improved in comparison with the traditional open-bay NICU. The single-family room environment appears more conducive to the provision of family-centered care. Improved parental satisfaction with care and the potential for enhanced family-centered care need to be considered in decisions made regarding the configuration of NICU facilities in the future.

  1. Rooming-In to Treat Neonatal Abstinence Syndrome: Improved Family-Centered Care at Lower Cost.

    PubMed

    Holmes, Alison Volpe; Atwood, Emily C; Whalen, Bonny; Beliveau, Johanna; Jarvis, J Dean; Matulis, John C; Ralston, Shawn L

    2016-06-01

    The incidence and associated costs of neonatal abstinence syndrome (NAS) have recently risen sharply; newborns with NAS occupy 4% of NICU beds. We implemented a coordinated program for NAS including standardized protocols for scoring, medications and weaning, and a calm rooming-in environment, to improve family-centered care and to decrease both length of stay (LOS) and hospital costs. In early 2013, a multidisciplinary quality improvement team began consecutive plan-do-study-act (PDSA) cycles. We trained nurses in modified Finnegan scoring, ensured scoring only after on-demand feeds during skin-to-skin care, and standardized physician score interpretation. We provided prenatal family education, increased family involvement in symptom monitoring and nonpharmacologic treatment, and treated otherwise healthy infants on the inpatient pediatric unit instead of in the NICU. We measured outcomes using statistical process control methods. At baseline, 46% of inborn infants at-risk for NAS were treated with morphine; by 2015, this decreased to 27%. Adjunctive use of phenobarbital decreased from 13% to 2% in the same period. Average LOS for morphine-treated newborns decreased from 16.9 to 12.3 days, average hospital costs per treated infant decreased from $19 737 to $8755, and costs per at-risk infant dropped from $11 000 to $5300. Cumulative morphine dose decreased from 13.7 to 6.6 mg per treated newborn. There were no adverse events, and 30-day readmission rates remained stable. A coordinated, standardized NAS program safely reduced pharmacologic therapy, LOS, and hospital costs. Rooming-in with family and decreased use of NICU beds were central to achieved outcomes. Copyright © 2016 by the American Academy of Pediatrics.

  2. Neonatal family care for 24 hours per day: effects on maternal confidence and breast-feeding.

    PubMed

    Wataker, Heidi; Meberg, Alf; Nestaas, Eirik

    2012-01-01

    In family care (FC) program for neonatal intensive care units (NICUs), parents are encouraged to reside together with their infant for 24 hours a day to actively be involved in the care. The aim of this study was to assess the impact of FC on maternal confidence and breast-feeding. Maternal confidence and rate of breast-feeding were assessed in 31 mothers offered FC that included special family rooms in the NICU, and in 30 mothers from a comparable NICU providing traditional care without such facilities. One week prior to hospital discharge, mothers in the FC group felt better informed regarding nursing issues and had more confidence in interpretation of the infants regarding feeding issues and in caregiving without staff attendance (P < .05). They also reported a higher level of empowerment (P < .05). Three months after discharge, the mothers in the FC group had a higher self-reported skill level for interpretation of the infant's signals and knowledge about breast-feeding (P < .05). Despite similar rate of breast-feeding at discharge, more infants in the FC group were breastfed 3 months after discharge (P < .05). An FC program in the NICU promoted better maternal confidence during the hospital stay and 3 months after discharge compared with traditional care.

  3. Relationship of household food insecurity to neonatal, infant, and under-five child mortality among families in rural Indonesia.

    PubMed

    Campbell, Ashley A; de Pee, Saskia; Sun, Kai; Kraemer, Klaus; Thorne-Lyman, Andrew; Moench-Pfanner, Regina; Sari, Mayang; Akhter, Nasima; Bloem, Martin W; Semba, Richard D

    2009-06-01

    Food insecurity is common in developing countries and is related to the physical well-being of families. Household food insecurity is intended to reflect a household's access, availability, and utilization of food, but its relationship with child mortality has not been well characterized. To examine the relationship of a modified household food insecurity score with a history of neonatal, infant, and under-five child mortality. In a cross-sectional study of 26,339 rural households in the Indonesian Nutrition Surveillance System, 2000-03, household food insecurity was measured with the use of a modified nine-item food security questionnaire. A simple food insecurity score of O to 9 was calculated based on responses and related to mortality history in the family. The proportion of households with neonatal, infant, and under-five child mortality was 4.6%, 8.8%, and 10.6%, respectively. In households with and without neonatal, infant, and under-five child mortality, the mean (+/- SD) food insecurity scores were 2.19 +/- 1.89 vs. 1.72 +/- 1.65, 2.29 +/- 1.94 vs. 1.69 +/- 1.63, and 2.29 +/- 1.93 vs. 1.68 +/- 1.62 (all p < .0001), respectively. The food insecurity score was related to mortality among neonates (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02 to 1.09; p = .003), infants (OR, 1.06; 95% CI, 1.03 to 1.09; p < .0001), and children under five (OR, 1.07; 95% CI, 1.04 to 1.10; p < .0001) after adjustment for potential confounders. Higher household food insecurity score is associated with greater neonatal, infant, and under-five child mortality among rural families in Indonesia. Greater household food insecurity may signify a higher risk of infant and young child mortality.

  4. Using appreciative inquiry to bring neonatal nurses and parents together to enhance family-centred care: A collaborative workshop.

    PubMed

    Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra

    2015-06-01

    Family-centred care (FCC) has been well recognised, accepted and reported in the literature as an optimised way of caring for hospitalised children. While neonatal units strive to adopt this philosophy, published research suggests there are difficulties implementing FCC principles in daily practice. Appreciative inquiry (AI) is a philosophy and methodology that offers a unique, strength-based approach to promoting organisational learning and positive organisational change. As a participatory approach, AI facilitates change from the ground up and lends itself to building effective partnerships or collaborations. This article reports the findings of a one-day workshop using an AI methodology to bring neonatal nurses and parents together to enhance the FCC within a neonatal intensive care unit in Sydney, Australia. Participants (n = 15) developed collaborative insights of optimal FCC that can be built upon to support neonates and their families in the future. Shared visions were formed, strategies identified and a development plan made for ongoing collaborations and partnerships. AI provides a flexible framework that enables the mandatory collaboration needed to develop action plans that can form the catalyst for organizational change in health-care research and practice.

  5. Mothers' perceptions of family centred care in neonatal intensive care units.

    PubMed

    Finlayson, Kenneth; Dixon, Annie; Smith, Chris; Dykes, Fiona; Flacking, Renee

    2014-10-01

    To explore mothers' perceptions of family centred care (FCC) in neonatal intensive care units (NICUs) in England. The qualitative experiences of 12 mothers from three NICUs in the UK were elicited using individual interviews. A thematic network analysis was conducted on the transcribed interviews A central global theme supported by a number of organizing themes were developed reflecting the views of the mothers and their experiences of FCC. A global theme of "Finding My Place" was identified, supported by six organizing themes: Mothering in Limbo; Deference to the Experts; Anxious Surveillance; Muted Relations, Power Struggles and Consistently Inconsistent. Mothers experienced a state of liminality and were acutely sensitive to power struggles, awkward relationships and inconsistencies in care. To try to maintain their equilibrium and protect their baby they formed deferential relationships with health professionals and remained in a state of anxious surveillance. This study illustrates that despite the rhetoric around the practice of FCC in NICUs, there was little in the mother's narratives to support this. It is of the utmost importance to minimize the consequences of the liminal experience, to improve staff-mother interactions and to facilitate mothers' opportunities to be primary caregivers. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Mitogenic cardiomyopathy: a lethal neonatal familial dilated cardiomyopathy characterized by myocyte hyperplasia and proliferation.

    PubMed

    Chang, Kenneth T E; Taylor, Glenn P; Meschino, Wendy S; Kantor, Paul F; Cutz, Ernest

    2010-07-01

    Pediatric cardiomyopathies are a heterogenous group of conditions of which dilated cardiomyopathies are the most common clinicomorphologic subtype. However, the etiology and pathogenesis of many cases of dilated cardiomyopathies remain unknown. We describe a series of 5 cases of a rare but clinically and histologically distinctive dilated cardiomyopathy that was uniformly lethal in early infancy. The 5 cases include 2 pairs of siblings. There was parental consanguinity in 1 of the 2 pairs of siblings. Death occurred in early infancy (range, 22-67 days; mean, 42 days) after a short history of general lethargy, decreased feeding, respiratory distress, or cyanosis. There was no specific birth or early neonatal problems. Autopsy revealed congestive cardiac failure and enlarged, dilated hearts with ventricular dilatation more pronounced than atrial dilatation, and endocardial fibroelastosis. Histology showed prominent hypertrophic nuclear changes of cardiac myofibers and markedly increased myocyte mitotic activity including occasional atypical mitoses. Immunohistochemical staining for Mib1 showed a markedly increased proliferative index of 10% to 20%. Ancillary investigations, including molecular studies, did not reveal a primary cause for the cardiomyopathies. This distinctive dilated cardiomyopathy characterized by unusual histologic features of myocyte nuclear hypertrophy and marked mitotic activity is lethal in early infancy. Its occurrence in 2 pairs of siblings suggests familial inheritance. Although the underlying molecular pathogenesis remains to be elucidated, it is important to recognize this distinctive entity for purposes of genetic counseling.

  7. Evaluation and development of potentially better practices for improving family-centered care in neonatal intensive care units.

    PubMed

    Saunders, Roger P; Abraham, Marie R; Crosby, Mary Jo; Thomas, Karen; Edwards, William H

    2003-04-01

    Technological and scientific advances have progressively decreased neonatal morbidity and mortality. Less attention has been given to meeting the psychosocial needs of the infant and family than on meeting the infant's physical needs. Parents' participation in making decisions and caring for their child has often been limited. Environments designed for efficient technological care may not be optimal for nurturing the growth and development of sick neonates or their families. Eleven centers collaborating on quality improvement tried to make the care of families better by focusing on understanding and improving family-centered care. Through internal process analysis, review of the evidence, collaborative learning, and benchmarking site visits to centers of excellence in family-centered care, a list of potentially better practices was developed. Choice of which practices to implement and methods of implementation were center specific. Improvement goals were in 3 areas: parent-reported outcomes, staff beliefs and practices, and clinical outcomes in length of stay and feeding practices. Measurement tools for the first 2 areas were developed and pilots were conducted. Length of stay and feeding outcomes were not different before the collaboration (1998) and at the formal end of the collaboration (2000). Prospective parent-reported outcomes are being collected, and the staff beliefs and practices questionnaire will be repeated in all centers to determine the impact of the project in those areas.

  8. A pilot cohort analytic study of Family Integrated Care in a Canadian neonatal intensive care unit

    PubMed Central

    2013-01-01

    Background We have developed a Family Integrated Care (FIC) model for use in a neonatal intensive care unit (NICU) where parents provide most of the care for their infant, while nurses teach and counsel parents. The objective of this pilot prospective cohort analytic study was to explore the feasibility, safety, and potential outcomes of implementing this model in a Canadian NICU. Methods Infants born ≤35 weeks gestation, receiving continuous positive airway pressure or less respiratory support, with a primary caregiver willing and able to spend ≥8 hours a day with their infant were eligible. Families attended daily education sessions and were mentored at the bedside by nurses. The primary outcome was weight gain, as measured by change in z-score for weight 21 days after enrolment. For each enrolled infant, we identified two matched controls from the previous year’s clinical database. Differences in weight gain between the two groups were analyzed using a linear mixed effects multivariable regression model. We also measured parental stress levels using the Parental Stress Survey: NICU, and interviewed parents and nurses regarding their experiences with FIC. Results This study included 42 mothers and their infants. Of the enrolled infants, matched control data were available for 31 who completed the study. The rate of change in weight gain was significantly higher in FIC infants compared with control infants (p < 0.05). There was also a significant increase in the incidence of breastfeeding at discharge (82.1 vs. 45.5%, p < 0.05). The mean Parental Stress Survey: NICU score for FIC mothers was 3.06 ± 0.12 at enrolment, which decreased significantly to 2.30 ± 0.13 at discharge (p < 0.05). Feedback from the parents and nurses indicated that FIC was feasible and appropriately implemented. Conclusions This study suggests that the FIC model is feasible and safe in a Canadian healthcare setting and results in improved weight gain among preterm infants. In addition

  9. Contiguous deletion of KCNQ2 and CHRNA4 may cause a different disorder from benign familial neonatal seizures☆

    PubMed Central

    Pascual, Franchette T.; Wierenga, Klaas J.; Ng, Yu-Tze

    2013-01-01

    Benign familial neonatal seizures (BFNS) is an autosomal dominant disorder associated with heterozygous mutations of either the KCNQ2 or KCNQ3 gene. Most cases have mutations of the KCNQ2 gene. A handful of cases with KCNQ2 and CHRNA4 deletions have been identified with different phenotypic presentations. Only two cases presented with typical BFNS features. Benign familial neonatal seizures is associated with normal exam and work-up, and seizure remission is seen in the first month of life. We report three unrelated individuals with KCNQ2 and CHRNA4 deletions, presenting with neonatal seizures and developmental delay. Their seizures started within one week after birth; all required antiepileptic drugs. Each had normal brain magnetic resonance imaging and at least two electroencephalograms with either normal or abnormal findings. All were developmentally delayed. None presented with autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) phenotype associated with CHRNA4 mutation. This study supports reports of KCNQ2 and CHRNA4 deletions associated with phenotypes different from typical BFNS. PMID:25667822

  10. [Single-family rooms for neonatal intensive care units impacts on preterm newborns, families, and health-care staff. A systematic literature review].

    PubMed

    Servel, A-C; Rideau Batista Novais, A

    2016-09-01

    The quality of the environment is an essential point in the care of preterm newborns. The design of neonatal intensive care units (NICUs) (open-bay, single-patient room, single-family room) directly affects both the preterm newborns and their caregivers (parents, healthcare staff). The aim of this systematic review was to evaluate the impact of single-family rooms on the preterm newborn, its parents, and the staff. Single-family rooms improve outcome for the preterm newborn, with increasing parental involvement and better control of the environment (fewer inappropriate stimulations such as high levels of noise and illumination). This kind of NICU design also improves parental and staff satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  11. Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers.

    PubMed

    Raffray, Marie; Semenic, Sonia; Osorio Galeano, Sandra; Ochoa Marín, Sandra Catalina

    2014-01-01

    To explore Colombian health care provider perceptions of barriers and facilitators to preparing families with premature infants for discharge home from the neonatal intensive care unit (NICU). Using a qualitative descriptive design, in-depth semi-structured interviews were conducted with fifteen neonatal health care providers (HCPs) in Colombia. Data were analyzed using qualitative content analysis. Participant responses centered on three main themes: 1) establishment of the parent-infant bond, 2) acquisition of parenting skills, and 3) getting ready for the transition from hospital to home. Barreirs to preparing parents for NICU discharge included obstacles to parental visiting in the NICU, communication barriers, difficulties related to the establishment of successful breastfeeding, insufficient human resources and poor links between hospital and community-based resources. Facilitators included the availability of social aids for vulnerable families, 24-hour telephone access to the neonatal units, tailored educational materials and group sessions, continuing education for staff and the community-based Kangaroo Program available to parents post-discharge. Adolescent mothers, indigenous parent and working fathers were identified as particularly challenging to reach and engage in discharge preparation. Neonatal HCPs identified numerous challenges as well as helpful strategies for preparing families for hospital discharge. Additional studies are needed on the experience of neonatal discharge from the perspective of parents of premature infants in Colombia, to help inform optimal interventions for supporting families during the transition from hospital to home.

  12. Familial olivopontocerebellar atrophy with neonatal onset: a recessively inherited syndrome with systemic and biochemical abnormalities.

    PubMed Central

    Harding, B N; Dunger, D B; Grant, D B; Erdohazi, M

    1988-01-01

    Clinical and pathological findings are reported in two siblings who presented in the neonatal period with failure to thrive, hypotonia, pericardial effusions, limitation of joint movement, retinal dystrophy and loss of visual function. Additional features were biochemical evidence of purine overproduction and liver dysfunction. Post mortem, the neuropathological findings in both children were typical of olivopontocerebellar atrophy. It is suggested that the cases represent a recessively inherited inborn error of metabolism. Images PMID:3162953

  13. Spiritual Needs of Families With Bereavement and Loss of an Infant in the Neonatal Intensive Care Unit: A Qualitative Study.

    PubMed

    Sadeghi, Narges; Hasanpour, Marzieh; Heidarzadeh, Mohamad; Alamolhoda, Aliakbar; Waldman, Elisha

    2016-07-01

    The hospital is a place full of distress and questions about the meaning of life. The death of a child can cause a spiritual struggle and crisis. Therefore, it is necessary for health care providers in the neonatal intensive care unit (NICU) to assess the spiritual needs of families that have lost a child. The purpose of this study was to explore the spiritual needs of families in Iran at the end of their baby's life and through bereavement in the NICU. This study was an exploratory qualitative study performed using purposeful sampling and semi-structured interviews with 24 participants. Inclusion criteria for families, nurses, and physicians included having experienced at least one newborn death in the last six months in the NICU. The research environment was the NICU in Isfahan, one of the largest cities in Iran. Data analysis revealed three main themes: spiritual belief in a supernatural power, the need for comfort of the soul, and human dignity for the newborn. The results of this study created a new vision in addressing spiritual needs of Iranian families who experience the death of a newborn. Copyright © 2016 American Academy of Hospice and Palliative Medicine. All rights reserved.

  14. Wolcott-Rallison Syndrome Is the Most Common Genetic Cause of Permanent Neonatal Diabetes in Consanguineous Families

    PubMed Central

    Rubio-Cabezas, Oscar; Patch, Ann-Marie; Minton, Jayne A. L.; Flanagan, Sarah E.; Edghill, Emma L.; Hussain, Khalid; Balafrej, Amina; Deeb, Asma; Buchanan, Charles R.; Jefferson, Ian G.; Mutair, Angham; Hattersley, Andrew T.; Ellard, Sian

    2009-01-01

    Context and Objective: Mutations in EIF2AK3 cause Wolcott-Rallison syndrome (WRS), a rare recessive disorder characterized by early-onset diabetes, skeletal abnormalities, and liver dysfunction. Although early diagnosis is important for clinical management, genetic testing is generally performed after the full clinical picture develops. We aimed to identify patients with WRS before any other abnormalities apart from diabetes are present and study the overall frequency of WRS among patients with permanent neonatal diabetes. Research Design and Methods: The coding regions of EIF2AK3 were sequenced in 34 probands with infancy-onset diabetes with a clinical phenotype suggestive of WRS (n = 28) or homozygosity at the WRS locus (n = 6). Results: Twenty-five probands (73.5%) were homozygous or compound heterozygous for mutations in EIF2AK3. Twenty of the 26 mutations identified were novel. Whereas a diagnosis of WRS was suspected before genetic testing in 22 probands, three patients with apparently isolated diabetes were diagnosed after identifying a large homozygous region encompassing EIF2AK3. In contrast to nonconsanguineous pedigrees, mutations in EIF2AK3 are the most common known genetic cause of diabetes among patients born to consanguineous parents (24 vs. < 2%). Age at diabetes onset and birth weight might be used to prioritize genetic testing in the latter group. Conclusions: WRS is the most common cause of permanent neonatal diabetes mellitus in consanguineous pedigrees. In addition to testing patients with a definite clinical diagnosis, EIF2AK3 should be tested in patients with isolated neonatal diabetes diagnosed after 3 wk of age from known consanguineous families, isolated populations, or countries in which inbreeding is frequent. PMID:19837917

  15. Multiple myeloma associated with an Evan's syndrome.

    PubMed

    Bechir, Achour; Haifa, Regaieg; Nesrine, Ben Sayed; Emna, Bouslema; Senda, Mejdoub; Asma, Achour; Amina, Bouatay Bouzouita; Mrabet, Senda; Yosra, Ben Youssef; Mondher, Kortas; Abderrahim, Khelif

    2016-01-01

    Auto-immun events are rare in multiple myeloma (MM). Here, we report one MM case complicated by Evans syndrome (Autoimmun hemolytic anemia (AIHA) associated with thrombocytopenia). A 52-year-old man was admitted in nephrology department with severe anemia, renal insufficiency and hypergamma globulinemia. Laboratory exams showed acute hemolysis due to an IgG warm autoantibody. Serum electrophoresis revealed the presence of a monoclonal IgG protein and urinary M protein was 2g/day. A whole body CT-Scan showed osteolytic lesions of vertebral body of C5, D4, L3, L4 and the left iliac wing. The diagnosis of multiple myeloma and Evan's syndrome was made, we underwent chemotherapy by BTD (bortezomib-thalidomide-dexamethasone) and continuous corticosteroid therapy but unfortunately the patient died secondary of a Lactic acidosis. The relationship between MM and hemolysis remain unclear.

  16. Letter to the Editor: Robert W. Evans

    NASA Astrophysics Data System (ADS)

    Johnston, A.

    2000-12-01

    I read the Letters page of the latest issue of the JBAA (2000 October) with some amusement. My very good friend Bob Evans had, according to the letter header, not only been elevated to the clergy, but had also transferred his nationality from Kiwi to Aussie. While he'll probably overlook the religious error he may not be so sanguine about being mistaken for an Australian.

  17. Neonatal intensive care unit discharge preparation, family readiness and infant outcomes: connecting the dots.

    PubMed

    Smith, V C; Hwang, S S; Dukhovny, D; Young, S; Pursley, D M

    2013-06-01

    Neonatal intensive care unit (NICU) discharge readiness is defined as the masterful attainment of technical skills and knowledge, emotional comfort, and confidence with infant care by the primary caregivers at the time of discharge. NICU discharge preparation is the process of facilitating comfort and confidence as well as the acquisition of knowledge and skills to successfully make the transition from the NICU to home. In this paper, we first review the literature about discharge readiness as it relates to the NICU population. Understanding that discharge readiness is achieved, in part, through successful discharge preparation, we then outline an approach to NICU discharge preparation.

  18. Development and Validation of an Instrument to Assess the Implementation of Family-Centred Care in Traditional Open Bay Neonatal Intensive Care Units

    ERIC Educational Resources Information Center

    Al-Motlaq, Mohammad A.; Abuidhail, Jamila; Salameh, Taghreed; Awwad, Wesam

    2017-01-01

    Objective: To develop an instrument to study family-centred care (FCC) in traditional open bay Neonatal Intensive Care Units (NICUs). Methods: The development process involved constructing instrument's items, establishing content validity by an expert panel and testing the instrument for validity and reliability with a convenience sample of 25…

  19. Development and Validation of an Instrument to Assess the Implementation of Family-Centred Care in Traditional Open Bay Neonatal Intensive Care Units

    ERIC Educational Resources Information Center

    Al-Motlaq, Mohammad A.; Abuidhail, Jamila; Salameh, Taghreed; Awwad, Wesam

    2017-01-01

    Objective: To develop an instrument to study family-centred care (FCC) in traditional open bay Neonatal Intensive Care Units (NICUs). Methods: The development process involved constructing instrument's items, establishing content validity by an expert panel and testing the instrument for validity and reliability with a convenience sample of 25…

  20. Evans blue is a specific antagonist of the human epithelial Na+ channel delta-subunit.

    PubMed

    Yamamura, Hisao; Ugawa, Shinya; Ueda, Takashi; Shimada, Shoichi

    2005-11-01

    The epithelial Na(+) channel (ENaC) regulates Na(+) homeostasis in cells and across epithelia. Four homologous ENaC subunits (alpha, beta, gamma, and delta) have been isolated in mammals. Combination of alpha-, beta-, and gamma-subunits or delta-, beta-, and gamma-subunits forms fully functional channels. Amiloride is a well known blocker of the ENaC family that inhibits both channel complexes. However, no specific antagonists are currently known that distinguish them. Here, we show that Evans blue, a diagnostic aid for the measurement of blood volume and vascular permeability, inhibits the activity of the delta-subunit expressed in Xenopus oocytes. The inward currents at a holding potential of -60 mV in human ENaCdeltabetagamma-expressing oocytes were inhibited by the application of Evans blue in a concentration-dependent manner with an IC(50) value of 143 muM. Evans blue markedly inhibited the delta-subunit current but did not block the alpha-subunit current. In conclusion, Evans blue is the first known delta-subunit-specific antagonist of ENaC. This finding provides us with a key compound for elucidating the physiological and pathological functions of ENaCdelta in humans and for drug development in the ENaC family.

  1. [Neonatal diabetes mellitus and KCNJ11 gene mutation: report of a family case].

    PubMed

    Orío Hernández, M; de la Serna Martínez, M; González Casado, I; Lapunzina, P; Gracia Bouthelier, R

    2008-06-01

    Neonatal diabetes mellitus (NDM) is characterized by hyperglycemia within the first month of life and insulin dependence for at least two weeks. There are two types of NDM, transient (TNDM) and permanent (PNDM), which are genetically different. We report the case of two brothers who developed hyperglycemia without ketosis on the 18th day and 2 h of life, respectively. Thyroid function tests, abdominal ultrasound and karyotype where normal and there were no pancreatic antibodies. The first one required insulin therapy for the first 92 days of life and the second for 5 months. The mother developed gestational diabetes during both pregnancies and she was later diagnosed diabetes mellitus (without antibodies). They were studied for mutations in KCNJ11 gene (principally related to the permanent form). The three of them showed the E229K mutation (frequently associated with the transient form). A genetic study is essential in NDM to achieve the most accurate prognosis possible.

  2. Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU.

    PubMed

    Davidson, Judy E; Aslakson, Rebecca A; Long, Ann C; Puntillo, Kathleen A; Kross, Erin K; Hart, Joanna; Cox, Christopher E; Wunsch, Hannah; Wickline, Mary A; Nunnally, Mark E; Netzer, Giora; Kentish-Barnes, Nancy; Sprung, Charles L; Hartog, Christiane S; Coombs, Maureen; Gerritsen, Rik T; Hopkins, Ramona O; Franck, Linda S; Skrobik, Yoanna; Kon, Alexander A; Scruth, Elizabeth A; Harvey, Maurene A; Lewis-Newby, Mithya; White, Douglas B; Swoboda, Sandra M; Cooke, Colin R; Levy, Mitchell M; Azoulay, Elie; Curtis, J Randall

    2017-01-01

    To provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU. We used the Council of Medical Specialty Societies principles for the development of clinical guidelines as the framework for guideline development. We assembled an international multidisciplinary team of 29 members with expertise in guideline development, evidence analysis, and family-centered care to revise the 2007 Clinical Practice Guidelines for support of the family in the patient-centered ICU. We conducted a scoping review of qualitative research that explored family-centered care in the ICU. Thematic analyses were conducted to support Population, Intervention, Comparison, Outcome question development. Patients and families validated the importance of interventions and outcomes. We then conducted a systematic review using the Grading of Recommendations, Assessment, Development and Evaluations methodology to make recommendations for practice. Recommendations were subjected to electronic voting with pre-established voting thresholds. No industry funding was associated with the guideline development. The scoping review yielded 683 qualitative studies; 228 were used for thematic analysis and Population, Intervention, Comparison, Outcome question development. The systematic review search yielded 4,158 reports after deduplication and 76 additional studies were added from alerts and hand searches; 238 studies met inclusion criteria. We made 23 recommendations from moderate, low, and very low level of evidence on the topics of: communication with family members, family presence, family support, consultations and ICU team members, and operational and environmental issues. We provide recommendations for future research and work-tools to support translation of the recommendations into practice. These guidelines identify the evidence base for best practices for family-centered care in the ICU. All recommendations were weak, highlighting the

  3. Transition to a New Neonatal Intensive Care Unit: Positive Effects on Staff Working Environment and How the Physical Environment Facilitates Family-Centered Care.

    PubMed

    van den Berg, Johannes; Bäck, Frida; Hed, Zara; Edvardsson, David

    To optimize family-centered care and the staff working environment, the physical care environment should be designed to meet the needs of the infants, their families, and staff. It is important to evaluate the effects of a purpose-built neonatal ward on staff perceptions of job strain, the psychosocial climate, and the appropriateness of the physical environment. This study collected information from staff at a neonatal intensive care unit (NICU), before and after the ward was relocated to a new NICU. Effects were measured using the following variables: job strain, person-centered climate and appropriateness-of-the-physical-environment questionnaires. Data were analyzed using repeated-measures generalized estimating equations and factor analysis. After staff began to work in the new NICU, their job strain significantly increased. At the 2-year follow-up, staff stress levels had returned to preintervention levels. Participating staff perceived the purpose-built neonatal ward as being a significantly more appropriate physical environment for family-centered care of the infants and their families. The staff also perceived the psychosocial climate of the new NICU as significantly more person-centered in terms of having a more homey, comfortable, and everyday ambience and thus experienced as being more supportive. An NICU built according to recommended standards optimized the physical care environment for family-centered care and increased the staff working climate.

  4. The Mount Evans Observatory -- Site Survey Update

    NASA Astrophysics Data System (ADS)

    Mack, J.; Stencel, R. E.; Klebe, D.; Sullivan, P.; Dirks, C.; Williams, J.; Emerson, G.; Meyer, E.

    1994-05-01

    The Astronomical Almanac lists Mt.Evans Observatory as the world's highest (Georgetown, Colorado, elev. 4,313 meters). We report on site observations conducted since our initial report (1993 Bull.A.A.S. 24:1240). Evidence will be provided that the site is competitive with the best, currently operational optical-infrared sites. The elevation difference between Denver and the summit is 9,000 feet, which strongly reduces the scattered light contribution to sky brightness. Astronomical seeing tests, as well as regional cloud cover statistics will be presented. The mid-continental location and elevation are responsible for minimal amounts of precipital water vapor (directly measured at 0.8mm in 1993 Sept. and estimated from observed temperature, pressure and relative humidity at the site to be even lower in winter months), giving the Mt.Evans site excellent infrared transparency. Three years of automated weather station data from the summit show the daily and annual temperature variations to be far from extreme, and the average wind field peaks daily at 20 knots out of the west. The treeless summit topography is favorable for laminar flow, which enhances optical/infrared image quality. Because Mt. Evans offers a potentially superior observatory site, we will also address the possiblities for future telescope development. The summit is easily accessible via a paved State Highway, and the unobstructed line of sight to the DU campus enhances the possibilities for remote operations. We are grateful to the estate of William Herschel Womble for providing funds in support of this investigation.

  5. "Giving us hope": Parent and neonatal staff views and expectations of a planned family-centred discharge process (Train-to-Home).

    PubMed

    Ingram, Jenny; Redshaw, Maggie; Manns, Sarah; Beasant, Lucy; Johnson, Debbie; Fleming, Peter; Pontin, David

    2017-08-01

    Preparing families and preterm infants for discharge is relatively unstructured in many UK neonatal units (NNUs). Family-centred neonatal care and discharge planning are recommended but variable. Qualitative interviews with 37 parents of infants in NNUs, and 18 nursing staff and 5 neonatal consultants explored their views of discharge planning and perceptions of a planned family-centred discharge process (Train-to-Home). Train-to-Home facilitates communication between staff and parents throughout the neonatal stay, using a laminated train and parent booklets. Parents were overwhelmingly positive about Train-to-Home. They described being given hope, feeling in control and having something visual to show their baby's progress. They reported positive involvement of fathers and families, how predicted discharge dates helped them prepare for home and ways staff engaged with Train-to-Home when communicating with them. Nursing staff reactions were mixed-some were uncertain about when to use it, but found the visual images powerful. Medical staff in all NNUs were positive about the intervention recognizing that it helped in communicating better with parents. Using a parent-centred approach to communication and informing parents about the needs and progress of their preterm infant in hospital is welcomed by parents and many staff. This approach meets the recommended prioritization of family-centred care for such families. Predicted discharge dates helped parents prepare for home, and the ways staff engaged with Train-to-Home when communicating with them helped them feel more confident as well as having something visual to show their baby's progress. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  6. Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England.

    PubMed

    Ingram, Jenny C; Powell, Jane E; Blair, Peter S; Pontin, David; Redshaw, Maggie; Manns, Sarah; Beasant, Lucy; Burden, Heather; Johnson, Debbie; Rose, Claire; Fleming, Peter J

    2016-03-10

    To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care. Before and after study, investigating the effects of the intervention during two 11-month periods before and after implementation. Four local neonatal units (LNUs) in South West England. Infants without major anomalies born at 27-33 weeks' gestation admitted to participating units, and their parents. A family-centred discharge package to increase parents' involvement and understanding of their baby's needs, comprising a train graphic and supporting care pathways to facilitate parents' understanding of their baby's progress and physiological maturation, combined with improved estimation of the likely discharge date. Perceived Maternal Parenting Self-Efficacy (PMP S-E) scores, infant length of stay (LOS) and healthcare utilisation for 8 weeks following discharge. Parents reported that the Train-to-Home improved understanding of their baby's progress and their preparedness for discharge. Despite a lack of change in PMP S-E scores with the intervention, the number of post-discharge visits to emergency departments (EDs) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p<0.05) after discharge. In both study phases, over 50% of infants went home more than 3 weeks before their estimated date of delivery (EDD), though no reduction in LOS occurred. Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Does family-centred neonatal discharge planning reduce healthcare usage? A before and after study in South West England

    PubMed Central

    Ingram, Jenny C; Powell, Jane E; Blair, Peter S; Pontin, David; Redshaw, Maggie; Manns, Sarah; Beasant, Lucy; Burden, Heather; Johnson, Debbie; Rose, Claire; Fleming, Peter J

    2016-01-01

    Objective To implement parent-oriented discharge planning (Train-to-Home) for preterm infants in neonatal care. Design Before and after study, investigating the effects of the intervention during two 11-month periods before and after implementation. Setting Four local neonatal units (LNUs) in South West England. Participants Infants without major anomalies born at 27–33 weeks’ gestation admitted to participating units, and their parents. Train-to-Home intervention A family-centred discharge package to increase parents’ involvement and understanding of their baby's needs, comprising a train graphic and supporting care pathways to facilitate parents’ understanding of their baby's progress and physiological maturation, combined with improved estimation of the likely discharge date. Main outcome measures Perceived Maternal Parenting Self-Efficacy (PMP S-E) scores, infant length of stay (LOS) and healthcare utilisation for 8 weeks following discharge. Results Parents reported that the Train-to-Home improved understanding of their baby's progress and their preparedness for discharge. Despite a lack of change in PMP S-E scores with the intervention, the number of post-discharge visits to emergency departments (EDs) fell from 31 to 20 (p<0.05), with a significant reduction in associated healthcare costs (£3400 to £2200; p<0.05) after discharge. In both study phases, over 50% of infants went home more than 3 weeks before their estimated date of delivery (EDD), though no reduction in LOS occurred. Conclusions Despite the lack of measurable effect on the parental self-efficacy scores, the reduction in ED attendances and associated costs supports the potential value of this approach. PMID:26966062

  8. Operations research to add postpartum family planning to maternal and neonatal health to improve birth spacing in Sylhet District, Bangladesh

    PubMed Central

    Ahmed, Salahuddin; Norton, Maureen; Williams, Emma; Ahmed, Saifuddin; Shah, Rasheduzzaman; Begum, Nazma; Mungia, Jaime; Lefevre, Amnesty; Al-Kabir, Ahmed; Winch, Peter J; McKaig, Catharine; Baqui, Abdullah H

    2013-01-01

    ABSTRACT Background: Short birth intervals are associated with increased risk of adverse maternal and neonatal health (MNH) outcomes. Improving postpartum contraceptive use is an important programmatic strategy to improve the health and well-being of women, newborns, and children. This article documents the intervention package and evaluation design of a study conducted in a rural district of Bangladesh to evaluate the effects of an integrated, community-based MNH and postpartum family planning program on contraceptive use and birth-interval lengths. Intervention: The study integrated family planning counseling within 5 community health worker (CHW)-household visits to pregnant and postpartum women, while a community mobilizer (CM) led community meetings on the importance of postpartum family planning and pregnancy spacing for maternal and child health. The CM and the CHWs emphasized 3 messages: (1) Use of the Lactational Amenorrhea Method (LAM) during the first 6 months postpartum and transition to another modern contraceptive method; (2) Exclusive, rather than fully or nearly fully, breastfeeding to support LAM effectiveness and good infant breastfeeding practices; (3) Use of a modern contraceptive method after a live birth for at least 24 months before attempting another pregnancy (a birth-to-birth interval of about 3 years) to support improved infant health and nutrition. CHWs provided only family planning counseling in the original study design, but we later added community-based distribution of methods, and referrals for clinical methods, to meet women's demand. Methods: Using a quasi-experimental design, and relying primarily on pre/post-household surveys, we selected pregnant women from 4 unions to receive the intervention (n = 2,280) and pregnant women from 4 other unions (n = 2,290) to serve as the comparison group. Enrollment occurred between 2007 and 2009, and data collection ended in January 2013. Preliminary Results: Formative research showed

  9. Effects of implementing family-centered rounds (FCRs) in a neonatal intensive care unit (NICU).

    PubMed

    Voos, Kristin C; Ross, Gail; Ward, Mary J; Yohay, Anne-Lise; Osorio, Snezana Nena; Perlman, Jeffrey M

    2011-11-01

    (1) Evaluate impact of FCR on provider satisfaction and collaboration. (2) Evaluate impact of FCR on parent satisfaction with provider communication. Collaboration and Satisfaction about Care Decisions (CSACD) questionnaire was given to staff on 4 patients 2 days a week for 5 weeks prior to and 6 months after implementation of FCR. Parents received a Parents Stress Scale and Neonatal Instrument of Parent Satisfaction before discharge, prior to and 6 months after starting FCR. 278/288 (97%) staff surveys were completed, 142 pre and 136 post. On the CSACD survey NNPs and fellows showed increased (p < 0.05) collaboration and satisfaction post FCR. No group had decreased satisfaction. Twenty-eight of 45 (62%) parent surveys were completed, 12 pre and 16 post. Parents' satisfaction scores increased (p < 0.01) pre vs. post on survey items regarding communication, meeting with physicians, and obtaining information about their infants. FCR was associated with enhanced collaboration among team members for NNPs and fellows. Parents' satisfaction scores increased post FCR on survey items regarding communication. Since NNPs and fellows are the primary communicators with parents, the increased satisfaction may reflect improved communication due to FCR. This added opportunity for open dialogue may also contribute to the increased parent satisfaction.

  10. Medical Decision-Making Among Adolescents with Neonatal Brachial Plexus Palsy and their Families: A Qualitative Study

    PubMed Central

    Squitieri, Lee; Larson, Bradley P.; Chang, Kate W-C; Yang, Lynda J-S.; Chung, Kevin C.

    2016-01-01

    Background Elective surgical management of neonatal brachial plexus palsy is complex, variable, and often individualized. Little is known about the medical decision-making process among adolescents with NBPP and their families faced with making complex treatment decisions. The experiences of these patients and their parents were analyzed to identify key factors in the decision-making process. Patients and Methods Eighteen adolescents with residual NBPP deficits between the ages of 10 to 17 years along with their parents were included in the present study. A qualitative research design was employed involving the use of separate one hour, in person, semi-structured interviews, which were audio recorded and transcribed. Grounded theory was applied by two independent members of the research team to identify recurrent themes and ultimately create a codebook that was then applied to the data. Results Medical decision-making among adolescents with NBPP and their families is multifaceted and individualized, comprised of both patient and system dependent factors. Four codes pertaining to the medical decision-making process were identified: 1) knowledge acquisition, 2) multidisciplinary care, 3) adolescent autonomy, and 4) patient expectations and treatment desires. Overall, parental decision-making was heavily influenced by system dependent factors, while adolescents largely based their medical decision-making on individual treatment desires to improve function and/or aesthetics. Conclusions There are many areas for improving the delivery of information and health care organization among adolescents with NBPP and their families. We recommend the development of educational interdisciplinary programs and decision aids containing evidence-based management guidelines targeted toward primary care providers and patients. We believe that a computer-based learning module may provide the best avenue to achieve maximum penetrance and convenience of information sharing. PMID:23714810

  11. [Family access to Neonatal Intensive Care Units in Latin America: A reality to improve].

    PubMed

    Montes Bueno, María Teresa; Quiroga, Ana; Rodríguez, Susana; Sola, Augusto

    2016-08-01

    Family access to NICUs has benefits for the newborn (NB) and family, as the main way of humanised care. To determine the current state of parents and families access to NICUs in Latin America. A cross-sectional study was conducted in 15 countries using two questionnaires: 1) directed at head nurses with management and supervision activities, and 2) nurses with care tasks. The features and modes of functioning were examined; the use access guides, personal opinion on the rights to enter, risks, interference, or collaboration as regards the patient, and nursing role in decisions. Nursing leaders of each country identified contacts and obtained authorisation under the regulations of each country. The responses were analysed centrally with the participants remaining anonymous. Out of 640 questionnaires issued, responses were received by 226 (35%). Among 52 NICU, 63% have a place for mothers to stay (only 27% overnight), and in 31 (60%) there are notices with fixed schedules for visiting the NB. Unrestricted access exists in only 19 NICU (36%), but for siblings and grandparents it is more restricted (it is not possible in 29%). Among the 174 nurses that responded, 76% feel that mothers should always have access, but these percentages decrease for fathers, siblings and grandparents. A large majority (77%) believe that nursing staff would favour access, and 35% would make it difficult. In addition, 48% believed that access interferes with nursing care. care. A cultural change is needed in the NICUs in Latin America in order to respect the rights of newborns and their families during hospitalisation. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: “Evocation of Being at Home”

    PubMed Central

    Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

    2016-01-01

    Background In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. Objectives The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. Methods This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen’s methodology. Results One of the essential themes that emerged in this study was the “evocation of being at home” among familial and even professional caregivers. This theme had three subthemes: i.e., “meta-family interaction,” “comprehensive support,” and “reconstruction of a normal family.” Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. Conclusions Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers’ points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this unit. PMID:28203324

  13. False Alarm: A Reply to Over and Evans. Discussion.

    ERIC Educational Resources Information Center

    Kirby, Kris N.

    1994-01-01

    Discusses Over and Evans' alternative interpretations to Kris N. Kirby's card-selection tasks and finds empirical difficulties. Cites the potentially important contribution of Over and Evans to understanding of the card-selection task by applying the notion of epistemic utility. (DR)

  14. A Comprehensive Comparison of Open-Bay and Single-Family-Room Neonatal Intensive Care Units at Sanford Children's Hospital.

    PubMed

    Stevens, Dennis C; Helseth, Carol C; Thompson, Paul A; Pottala, James V; Khan, M Akram; Munson, David P

    2012-01-01

    This paper summarizes the results of a comprehensive comparison of open-bay (OPBY) and single-family-room (SFR) neonatal intensive care unit (NICU) designs. The NICU expanded from 7000 ft(2) in two large rooms to 27,000 ft(2) with 45 individual family spaces. Sound measurements indicated a significant reduction in the unoccupied SFR to less than half of the levels in the OPBY NICU. However, respiratory support equipment generated levels well above those of the ambient environment. Illumination was significantly reduced in the SFR. Ambient illumination in nursing work areas was less than recommended. In other comparisons with the OPBY NICU the SFR NICU was shown to have: a shorter interval until full enteric feedings were established; improved parent satisfaction; improved staff perceptions of the environment and care; a decrease in nurses State-Trait Anxiety scores; an increased need for total numbers of staff and nursing staff per shift; increased walking per shift by nurses and nurse practitioners; and improved sleep time in a very small sample of patients. Analysis of the cost of construction showed comparable cost per ft(2); however, the cost per bed in the SFR NICU was much greater because of the increased area of this facility. Highly notable findings of this investigation included the same incidence of adverse outcomes of care and a reduction in the adjusted direct cost of care in the SFR NICU. These data overwhelmingly support the SFR NICU in preference to the traditional OPBY facility. They substantiate that the SFR NICU should be the new standard for NICU care.

  15. A family support intervention to reduce stress among parents of preterm infants in neonatal intensive care unit

    PubMed Central

    Abdeyazdan, Zahra; Shahkolahi, Zahra; Mehrabi, Tayebeh; Hajiheidari, Mahnoosh

    2014-01-01

    Background: Preterm infants constitute a large proportion of the newborn population in the neonatal intensive care units (NICUs). Parents, as the main members of the care team, are not adequately supported as the focus is chiefly on infant care. The present study aimed to evaluate the effect of a family support intervention on the stress levels among the parents of preterm infants in NICU. Materials and Methods: In this quasi-experimental study, convenience sampling method was used to select 50 parents of preterm infants. The subjects were allocated to two groups of intervention and control (n = 25 pairs in each). While the control group received routine care, the intervention group benefitted from a two-stage family support program (including informational and observational phases in the first stage and emotional supportive intervention in the second). The Parental Stressor Scale-NICU (PSS-NICU) was completed by both fathers and mothers of the two groups (before and after intervention). Descriptive and inferential statistics were employed to analyze data in SPSS version 18. Results: Before the intervention, the mean total scores of PSS-NICU and also the mean scores of its three subscales were not significantly different between the two groups. However, after the intervention, significant differences were observed between the two groups. The scores of the intervention group showed significant reduction following the intervention, but such a difference was not detected in the control group. Conclusions: Apparently, early educational and emotional support for parents of preterm infants decreased their stress. Similar interventions may thus be effective in empowering parents for caring of their infant and playing their parental role. PMID:25183973

  16. Taking care of the newborn dying and their families: Nurses' experiences of neonatal intensive care.

    PubMed

    Almeida, Fabiane de Amorim; Moraes, Mariana Salim de; Cunha, Mariana Lucas da Rocha

    2016-06-01

    To understand the experiences of nurses when caring for dying newborns and their families in the NICU; and redeem their perceptions about acting before the death and grieving process. A descriptive exploratory study with a qualitative approach, developed with nine nurses at the ICU of a hospital in São Paulo (SP), Brazil. Data was collected through semi-structured interviews and analyzed using the Collective Subject Discourse (CSD). Caring for newborns who are dying and their families is very difficult for nurses, due to the intense involvement. They seek strategies to deal with the situation and, before the newborn's death, despite the suffering, express the feeling of accomplishment. Facing death and grief triggers mechanisms that emerge life references, coming across painful issues. Learning to deal with these questions is a daily challenge for nurses of the NICU. Compreender as experiências vivenciadas por enfermeiros ao cuidar de neonatos que estão morrendo e seus familiares na UTIN; e resgatar as suas percepções sobre a atuação diante do processo de morte e luto. Estudo descritivo exploratório, de abordagem qualitativa, desenvolvido com nove enfermeiras da UTIN de um hospital de São Paulo (SP), Brasil. Os dados foram coletados por meio de entrevista semi-estruturada e analisados pela técnica do Discurso de Sujeito Coletivo (DSC). Cuidar de neonatos que estão morrendo e suas famílias é muito difícil para as enfermeiras, devido ao intenso envolvimento. Buscam estratégias para lidar com a situação e, diante do óbito do neonato, apesar do sofrimento, manifestam o sentimento de dever cumprido. Enfrentar a morte e o luto aciona mecanismos que afloram referências de vida, deparando-se com questões dolorosas. Aprender a lidar com essas questões é um desafio diário para os enfermeiros de UTIN.

  17. Sensitive blood-retinal barrier breakdown quantitation using Evans blue.

    PubMed

    Xu, Q; Qaum, T; Adamis, A P

    2001-03-01

    This study investigated whether a nonradioactive dye, Evans blue, can be adapted as a safe alternative to the isotope-dilution method for quantitating blood-retinal barrier breakdown. Blood-retinal barrier breakdown was induced in rats with vascular endothelial growth factor (VEGF) or through the induction of diabetes. After allowing Evans blue to circulate in the vasculature, the dye was cleared from the bloodstream with saline, citrate, or citrate-buffered paraformaldehyde, and the efficacies of the perfusion solutions were compared. Extravasated dye was detected at 620 nm and was normalized against the time-averaged Evans blue plasma concentration, the circulation time, and also against wet and dry retina weights. Evans blue leakage from retinas treated with VEGF was 4.0-fold higher than that of contralateral untreated eyes (n = 6 rats, P: < 0.05). Retinal Evans blue leakage of eyes from 1-week diabetic animals (n = 11 retinas) was 1.7-fold higher (P: < 0.05) than that of nondiabetic controls (n = 10 retinas). Intra-animal, inter-retina weights showed significantly less variability (P: < 0.05) with the use of dry weights (11.2%, n = 74 retina pairs) than with wet weights (20.5%, n = 93 retina pairs). The Evans blue dye technique can be modified to be as sensitive and quantitative as the isotope-dilution method for measuring blood-retinal barrier breakdown. The advantages of the Evans blue technique are its safety, relative simplicity, and economy.

  18. GESTATIONAL MERCURY VAPOR EXPOSURE AND DIET CONTRIBUTE TO MERCURY ACCUMULATION IN NEONATAL RATS.

    EPA Science Inventory

    Exposure of pregnant Long-Evans rats to elemental mercury (Hg0) vapor resulted in a significant

    accumulation of Hg in tissues of neonates. Because elevated Hg in neonatal tissues may adversely

    affect growth and development, we were interested in how rapidly Hg was...

  19. Neurodevelopmental long-term outcome in children with hydrocephalus requiring neonatal surgical treatment.

    PubMed

    Melot, A; Labarre, A; Vanhulle, C; Rondeau, S; Brasseur, M; Gilard, V; Castel, H; Marret, S; Proust, F

    2016-04-01

    To assess long-term neurodevelopmental outcome in children with hydrocephalus requiring neurosurgical treatment during the neonatal period. This prospective longitudinal population-based study included 43 children with neonatal shunted hydrocephalus. The 43 children were prospectively reviewed in the presence of their parents at the outpatient clinic. Cognitive and motor outcomes were assessed respectively using different Wechsler scales according to age and Gross Motor Function Classification System (GMFCS). Postoperative MRI was routinely performed. The mean gestational age at birth of the 43 consecutive children with neonatal hydrocephalus (sex ratio M/F: 1.39) was 34.5±5.4 weeks of gestation. At mean follow-up of 10.4±4 years, mean total IQ was 73±27.7, with equivalent results in mean verbal and mean performance IQ. Of the 33 children with IQ evaluation, 18 presented an IQ≥85 (41.9%). Efficiency in walking without a mobility device (GMFCS≤2) was obtained in 37 children (86%). Only severity of postoperative ventricular dilation was significantly associated with unfavorable outcome (Evans index>0.37; odds ratio: 0.16, P=0.03). This information could be provided to those families concerned who often experience anxiety when multi-disciplinary management of neonatal hydrocephalus is required. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Family centered maternity care: its relationship to perinatal regionalization and neonatal intensive care.

    PubMed

    Swartz, W H; Swartz, J V

    1976-09-01

    For several months prior to birth a major portion of a family's attention, conversation, thought, and often worry, is directed toward the idea of a new child. This prolonged attention and anticipation contribute to making childbirth an emotionally charged experience. In psychological terms, it is therefore a critical period of peak motivation for learning, and a time to peak susceptibility to reinforcement. Theory, reason, and scientific evidence indicate thng with childbirth and early postpartum experiences, can significantly affect subsequent parental behaviors, the child's central environment influence. Evidence strongly suggests that these parental attitudes and behaviors so crucial to the child's ultimate well-being are learned rather than derived instinctually, and therefore they are malleable and can be taught, directed, and corrected. Through education and reinforcement it is possible to encourage parental behaviors and child interactions which are products of feelings of control, competence, accomplishment, understanding, and caring. Similarly we can recognize and work toward replacing attitudes, feelings, and behaviors that express fear, worry, and insecurity about the child. Over the past 50 years major changes have occurred in the practice of obstetrics and newborn pediatrics. Other major changes will necessarily occur as we move toward perinatal regionalization. Changes instigated solely on physiologic data can have unrecognized collateral effects on the psychological component of the childbirth experience. All concerned health care personnel, especially obstetricians and pediatricians, can insist that the importance of desirable mother-father-child interactions be recognized and that practices fostering them be afforded a high priority. I would like to endorse a comment from a recent article by Richmond concerning the advent of behavioral pediatrics by adding that behavioral obstetrics is also "an idea whose time has arrived".

  1. Astronaut Ronald Evans photographed during transearth coast EVA

    NASA Image and Video Library

    1972-12-17

    AS17-152-23391 (17 Dec. 1972) --- Astronaut Ronald E. Evans is photographed performing extravehicular activity during the Apollo 17 spacecraft's trans-Earth coast. During his EVA, Evans, command module pilot, retrieved film cassettes from the lunar sounder, mapping camera and panoramic camera. The cylindrical object at Evans' left side is the mapping camera cassette. The total time for the trans-Earth EVA was one hour, seven minutes, 18 seconds, starting at ground elapsed time of 257:25 (2:28 p.m.) and ending at G.E.T. of 258:42 (3:35 p.m.) on Sunday, Dec. 17, 1972.

  2. Astronaut Ronald Evans photographed during transearth coast EVA

    NASA Image and Video Library

    1972-12-17

    AS17-152-23393 (17 Dec. 1972) --- Astronaut Ronald E. Evans is photographed performing extravehicular activity during the Apollo 17 spacecraft's trans-Earth coast. During his EVA, command module pilot Evans retrieved film cassettes from the Lunar Sounder, Mapping Camera, and Panoramic Camera. The cylindrical object at Evans' left side is the Mapping Camera cassette. The total time for the trans-Earth EVA was one hour seven minutes 18 seconds, starting at ground elapsed time of 257:25 (2:28 p.m.) and ending at ground elapsed timed of 258:42 (3:35 p.m.) on Sunday, Dec. 17, 1972.

  3. Family Integrated Care (FICare) in Level II Neonatal Intensive Care Units: study protocol for a cluster randomized controlled trial.

    PubMed

    Benzies, Karen M; Shah, Vibhuti; Aziz, Khalid; Isaranuwatchai, Wanrudee; Palacio-Derflingher, Luz; Scotland, Jeanne; Larocque, Jill; Mrklas, Kelly; Suter, Esther; Naugler, Christopher; Stelfox, Henry T; Chari, Radha; Lodha, Abhay

    2017-10-10

    Every year, about 15 million of the world's infants are born preterm (before 37 weeks gestation). In Alberta, the preterm birth rate was 8.7% in 2015, the second highest among Canadian provinces. Approximately 20% of preterm infants are born before 32 weeks gestation (early preterm), and require care in a Level III neonatal intensive care unit (NICU); 80% are born moderate (32 weeks and zero days [32(0/7)] to 33(6/7) weeks) and late preterm (34(0/7) to 36(6/7) weeks), and require care in a Level II NICU. Preterm birth and experiences in the NICU disrupt early parent-infant relationships and induce parental psychosocial distress. Family Integrated Care (FICare) shows promise as a model of care in Level III NICUs. The purpose of this study is to evaluate length of stay, infant and maternal clinical outcomes, and costs following adaptation and implementation of FICare in Level II NICUs. We will conduct a pragmatic, cluster randomized controlled trial (cRCT) in ten Alberta Level II NICUs allocated to one of two groups: FICare or standard care. The FICare Alberta model involves three theoretically-based, standardized components: information sharing, parenting education, and family support. Our sample size of 181 mother-infant dyads per group is based on the primary outcome of NICU length of stay, 80% participation, and 80% retention at follow-up. Secondary outcomes (e.g., infant clinical outcomes and maternal psychosocial distress) will be assessed shortly after admission to NICU, at discharge and 2 months corrected age. We will conduct economic analysis from two perspectives: the public healthcare payer and society. To understand the utility, acceptability, and impact of FICare, qualitative interviews will be conducted with a subset of mothers at the 2-month follow-up, and with hospital administrators and healthcare providers near the end of the study. Results of this pragmatic cRCT of FICare in Alberta Level II NICUs will inform policy decisions by

  4. Struvite Urolithiasis in Long-Evans Rats.

    PubMed

    Pang, Jassia; Borjeson, Tiffany M; Parry, Nicola M A; Fox, James G

    2015-12-01

    Struvite urinary calculi, which are composed of magnesium, ammonium, and phosphate, can cause complications including sepsis and renal failure. Struvite calculi were identified within the urinary bladder and renal pelvis of 2 Long-Evans rats that died within days after arrival from a commercial vendor. The remaining rats in the shipment were screened by physical examination, radiography, and ultrasonography, revealing an additional 2 animals that were clinically affected. These rats were euthanized, necropsied, and yielded similar findings to those from the first 2 rats. In addition, urine samples had an alkaline pH and contained numerous bacteria (predominantly Proteus mirabilis), leukocytes, and crystals. All calculi were composed completely of struvite. Another 7 rats in the shipment had alkaline urine with the presence of blood cells; 6 of these rats also had abundant struvite crystals, and P. mirabilis was cultured from the urine of 3 rats. Further investigation by the vendor identified 2 of 100 rats with struvite calculi from the same colony. Although no specific cause could be implicated, the fact that all the affected rats came from the same breeding area suggests a genetic or environmental triggering event; a contribution due to diet cannot be ruled out. Our findings suggest that the affected rats had metabolic disturbances coupled with bacterial infection that predisposed them to develop struvite calculi. During sudden increases of struvite urinary calculi cases in rats, urine cultures followed by appropriate surgical intervention and antibiotic therapy is warranted. Additional factors, including diet, merit attention as well.

  5. Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 2), Manchester, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 2), Manchester, 1873 (PL XXIX top); illustration of full milll, as enlarged to south. - Harmony Manufacturing Company, Mill Number 3, 100 North Mohawk Street, Cohoes, Albany County, NY

  6. Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 1), Manchester, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 1), Manchester, 1873 (PL XXI); illustration of turbine and belt system. - Harmony Manufacturing Company, Mill Number 3, 100 North Mohawk Street, Cohoes, Albany County, NY

  7. 11. Architect's rendering of the Arcade Building by Furness, Evans ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. Architect's rendering of the Arcade Building by Furness, Evans and Co., from Moses King's Philadelphia and Notable Philadelphians, published 1902 for the City's 220th birthday - Arcade Building, Fifteenth & Market Streets, Philadelphia, Philadelphia County, PA

  8. Familial very long chain acyl-CoA dehydrogenase deficiency as a cause of neonatal sudden infant death: improved survival by prompt diagnosis.

    PubMed

    Scalais, Emmanuel; Bottu, Jean; Wanders, Ronald J A; Ferdinandusse, Sacha; Waterham, Hans R; De Meirleir, Linda

    2015-01-01

    In neonates, very long chain acyl-CoA dehydrogenase (VLCAD) deficiency is often characterized by cardiomyopathy, hepatic encephalopathy, or severe hypoketotic hypoglycemia, or a combination thereof. The purpose of this study was to further elucidate a familial VLCAD deficiency in three patients, two of whom died in the neonatal period. We report on a family with VLCAD deficiency. Acyl-carnitine profiles were obtained from dried blood spot and/or from oxidation of (13) C-palmitate by cultured skin fibroblasts. In the index patient, VLCAD deficiency was ascertained by enzyme activity measurement in fibroblasts and by molecular analysis of ACADVL. At 30 hr of life, the proband was diagnosed with hypoglycemia (1.77 mmol/L), rhabdomyolysis (CK: 12966 IU/L) and hyperlactacidemia (10.6 mmol/L). Acylcarnitine profile performed at 31 hr of life was consistent with VLCAD deficiency and confirmed by cultured skin fibroblast enzyme activity measurement. Molecular analysis of ACADVL revealed a homozygous splice-site mutation (1077 + 2T>C). The acyl-carnitine profile obtained from the sibling's original newborn screening cards demonstrated a similar, but less pronounced abnormal profile. In the proband, the initial metabolic crisis was controlled with 10% dextrose solution and oral riboflavin followed by specific diet (Basic-F and medium chain triglyceride (MCT). This clinical report demonstrates a familial history of repeated neonatal deaths explained by VLCAD deficiency, and the clinical evolution of the latest affected, surviving sibling. It shows that very early metabolic screening is an effective approach to avoid sudden unexpected death.

  9. Self-efficacy scale for the establishment of good relationships with families in neonatal and pediatric hospital settings.

    PubMed

    Cruz, Andréia Cascaes; Angelo, Margareth; Santos, Bernardo Pereira Dos

    2017-05-25

    The purpose of this study was to develop and test the psychometric properties of the Self-efficacy Scale for the Establishment of Good Relationships with Families in Neonatal and Pediatric Hospital Settings. Methodological study grounded on self-efficacy theory was conducted in three phases: conceptual and operational definition (review of the literature and interviews with the target population), content validity (opinion of five experts e three clinical nurses), and exploratory factor analysis and internal consistency reliability (cross-sectional survey with a valid sample of 194 nurses). A ten-point Likert scale with 40-item was designed and one item was excluded after review by experts. Three factors emerged from the exploratory factor analysis. The Cronbach's alpha for all items was 0.983 with item-total correlations in the range 0.657 to 0.847. Cronbach's alpha value if item deleted were less than or equal to 0.983. The final version of the scale demonstrated psychometric adequacy. It is a useful tool to be administered in the clinical, educational and research nursing fields to measure nurses' self-efficacy beliefs concerning the establishment of good relationships with families. El propósito de este estudio fue desarrollar y probar las propiedades psicométricas de la Escala de Autoeficacia para el Establecimiento de Buenas Relaciones con las Familias en Ambientes Neonatales y Pediátricos. Estudio metodológico fundamentado en la teoría de la auto-eficacia se realizó en tres fases: conceptual y definición operacional (revisión de la literatura y entrevistas con la población objetivo), la validez de contenido (opinión de cinco expertos y tres enfermeras clínicas), y el factor de análisis exploratorio e fiabilidad interna de consistencia (estudio transversal con una muestra válida de 194 enfermeras). La escala de Likert de diez puntos con 40 ítems fue diseñada y un elemento fue excluido después de la revisión por expertos. Hay tres factores que

  10. Complications in neonatal surgery.

    PubMed

    Escobar, Mauricio A; Caty, Michael G

    2016-12-01

    Neonatal surgery is recognized as an independent discipline in general surgery, requiring the expertise of pediatric surgeons to optimize outcomes in infants with surgical conditions. Survival following neonatal surgery has improved dramatically in the past 60 years. Improvements in pediatric surgical outcomes are in part attributable to improved understanding of neonatal physiology, specialized pediatric anesthesia, neonatal critical care including sophisticated cardiopulmonary support, utilization of parenteral nutrition and adjustments in fluid management, refinement of surgical technique, and advances in surgical technology including minimally invasive options. Nevertheless, short and long-term complications following neonatal surgery continue to have profound and sometimes lasting effects on individual patients, families, and society. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Differential regulation of Krüppel-like factor family transcription factor expression in neonatal rat cardiac myocytes: Effects of endothelin-1, oxidative stress and cytokines

    PubMed Central

    Cullingford, Timothy E.; Butler, Matthew J.; Marshall, Andrew K.; Tham, El Li; Sugden, Peter H.; Clerk, Angela

    2008-01-01

    Krüppel-like transcription factors (Klfs) modulate fundamental cell processes. Cardiac myocytes are terminally-differentiated, but hypertrophy in response to stimuli such as endothelin-1. H2O2 or cytokines promote myocyte apoptosis. Microarray studies of neonatal rat myocytes identified several Klfs as endothelin-1-responsive genes. We used quantitative PCR for further analysis of Klf expression in neonatal rat myocytes. In response to endothelin-1, Klf2 mRNA expression was rapidly increased (∼ 9-fold; 15–30 min) with later increases in expression of Klf4 and Klf6 (∼ 5-fold; 30–60 min). All were regulated as immediate early genes (cycloheximide did not inhibit the increases in expression). Klf5 expression was increased at 1–2 h (∼ 13-fold) as a second phase response (cycloheximide inhibited the increase). These increases were transient and attenuated by U0126. H2O2 increased expression of Klf2, Klf4 and Klf6, but interleukin-1β or tumor necrosis factor α downregulated Klf2 expression with no effect on Klf4 or Klf6. Of the Klfs which repress transcription, endothelin-1 rapidly downregulated expression of Klf3, Klf11 and Klf15. The dynamic regulation of expression of multiple Klf family members in cardiac myocytes suggests that, as a family, they are actively involved in regulating phenotypic responses (hypertrophy and apoptosis) to extracellular stimuli. PMID:18406357

  12. Jung, Evans-Wentz and various other gurus.

    PubMed

    McGuire, William

    2003-09-01

    How did Jung become deeply concerned with Asian religions and particularly with the Tibetan Buddhism of a Welshman from Trenton, New Jersey? Could that man be considered one of Jung's gurus? This essay begins six years after Jung, at twenty, was admitted to the medical school of Basel University and became a member of the Zofingiaverein, a student society. The next year he gave the first of a series of lectures on the interpretation of Christ as the model of the 'god-man', like the Apostle Paul, Confucius, Zoroaster and the Buddha, who was 'drummed into the Hindu boy'. (Jung's Zofingia Lectures were discovered only after his death, in 1961, and were published in English in 1983). The present essay discusses Jung's early Buddhist interest as displayed in The Psychology of the Unconscious (finally, in a revision, entitled Symbols of Transformation), in Psychological Types and later in his foreword of the Wilhelm translation of the I Ching. Jung was influenced by the gurus Richard Wilhelm and his son Hellmut, the scholar J. W. Hauer (with whom he later broke off relations because of Hauer's Nazi politics), the indologist Heinrich Zimmer, and the Zen master D. T. Suzuki. Walter Yeeling Wentz was born in Trenton in 1878 and brought up in his family's theosophist faith. The Wentzes moved to San Diego in 1900, and Walter added his mother's Celtic surname, Evans, to the German Wentz. He was educated at Stanford University and travelled in Europe, studying Celtic folklore, and widely in the Near East, Tibet, India, and Oxford--studying religions everywhere and editing Tibetan books. He lived his last decades in San Diego and conducted a correspondence with Jung, while living in a cheap hotel, or in an ashram.

  13. Evans Blue and other dyes as protein tyrosine phosphatase inhibitors.

    PubMed

    Shrestha, Suja; Shim, Yi Sup; Kim, Ki Chul; Lee, Keun-Hyeung; Cho, Hyeongjin

    2004-04-19

    Commonly used dyes including Evans Blue and Trypan Blue were examined for their inhibitory activities against protein tyrosine phosphatases (PTPases), all of them showed inhibition of PTPases with different potencies. Of the 13 dyes tested, four exhibited IC(50) value of less than 10 microM, Evans Blue lowest IC(50) of 1.3 microM against PTP1B. Care must be taken in the use of dyes for clinical or biochemical experiments to avoid unwanted side effects. Some of the low molecular weight dyes might be useful as lead compounds for the development of potent and selective PTPase inhibitors.

  14. Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 1), Manchester, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Photocopy from Evan Leigh's Modern Cotton Spinning (Vol 1), Manchester, 1873 (PL XX); illustration used by eminent British textile engineer to exemplify the ultimate development in American cotton mill technology. - Harmony Manufacturing Company, Mill Number 3, 100 North Mohawk Street, Cohoes, Albany County, NY

  15. Integrated Psychological Services in the Greeley-Evans Public Schools

    ERIC Educational Resources Information Center

    Nelson, R. Brett; Hoover, Michael; Young, Mary; Obrzut, Ann; D'Amato, Rik Carl; Copeland, Ellis P.

    2006-01-01

    Integrated school psychological services were implemented 12 years ago in the Greeley-Evans Public Schools by combining the positions of school psychologist and school social worker and placing each professional in an elementary school full-time. After 5 years, services were expanded to secondary schools such that all schools had a full-time…

  16. Family Nurture Intervention in the Neonatal Intensive Care Unit Improves Social-Relatedness, Attention, and Neurodevelopment of Preterm Infants at 18 Months in a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Welch, Martha G.; Firestein, Morgan R.; Austin, Judy; Hane, Amie A.; Stark, Raymond I.; Hofer, Myron A.; Garland, Marianne; Glickstein, Sara B.; Brunelli, Susan A.; Ludwig, Robert J.; Myers, Michael M.

    2015-01-01

    Background: Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Methods: Data…

  17. Family Nurture Intervention in the Neonatal Intensive Care Unit Improves Social-Relatedness, Attention, and Neurodevelopment of Preterm Infants at 18 Months in a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Welch, Martha G.; Firestein, Morgan R.; Austin, Judy; Hane, Amie A.; Stark, Raymond I.; Hofer, Myron A.; Garland, Marianne; Glickstein, Sara B.; Brunelli, Susan A.; Ludwig, Robert J.; Myers, Michael M.

    2015-01-01

    Background: Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Methods: Data…

  18. Neonatal sepsis.

    PubMed

    Stefanovic, Iva Mihatov

    2011-01-01

    Neonatal sepsis is the most common cause of neonatal deaths with high mortality despite treatment. Neonatal sepsis can be classified into two subtypes depending upon onset of symptoms. There are many factors that make neonates more susceptable to infection. Signs of sepsis in neonates are often non-specific and high degree of suspicion is needed for early diagnosis. Some laboratory parameters can be helpful for screening of neonates with neonatal sepsis, but none of it is specific and sensitive enough to be used singly. Diagnostic approach mostly focuses on history and review of non specific signs and symptoms. Antibiotic treatment is the mainstay of treatment and supportive care is equally important. The aim of this review is to give an overview of neonatal sepsis, including incidence, etiology, clinical picture, diagnostics and therapy.

  19. Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial.

    PubMed

    Hane, Amie A; Myers, Michael M; Hofer, Myron A; Ludwig, Robert J; Halperin, Meeka S; Austin, Judy; Glickstein, Sara B; Welch, Martha G

    2015-04-01

    This study assessed the impact of Family Nurture Intervention (FNI) on the quality of maternal caregiving behavior (MCB) while in the neonatal intensive care unit (NICU). FNI is a randomized controlled trial conducted in a high-acuity NICU to facilitate an emotional connection between mothers and their premature infants. FNI begins shortly after birth, continues until discharge, and involves mother/infant calming sessions that include scent cloth exchange, vocal soothing and emotion expression, eye contact, skin-to-skin and clothed holding, and family-based support sessions. Maternal caregiving behavior was coded during a single holding and feeding session (∼30 min) in the NICU before discharge at approximately 36 weeks gestational age (GA). Sixty-five mothers and their premature infants (34 male, 31 female; 26-34 wk GA) were included in these analyses (FNI, n = 35; standard care [SC], n = 30). Relative to mothers in the SC condition, those in the FNI group showed significantly higher quality MCB, which remained significant when controlling for birth order, twin status, maternal depression, and maternal anxiety. This is the first study to demonstrate that in-unit MCB can be enhanced by a hospital-based intervention. FNI provides a new rationale for integrating nurture-based interventions into standard NICU care.

  20. Closet addiction in fiction: the search for Christiana Evans.

    PubMed

    Sibley, Gay

    2007-01-01

    Mary Ann Evans, who would later become the great nineteenth-century novelist George Eliot, takes up in her first three works of fiction a discussion of the use of alcohol in her own culture. However, it is in "Adam Bede" (1859) that a significant portion of the discussion (the alcoholism of one female character in particular) is so deliberately closeted -- so backgrounded -- that the structure of the text becomes a slippery portrait, not only of the extent to which the culturally pervasive alcoholism of women was persistently denied, but of Eliot's own mother's hidden substance abuse. An important minor character in "Adam Bede," identified by more than one biographer as having a kinship to Eliot's mother Christiana Evans, shows all the signs and symptoms of alcoholism, a phenomenon which even the story's narrator appears to be hiding from the reader.

  1. Response to the comments by J.H. Evans

    SciTech Connect

    Barashev, Aleksandr; Golubov, Stanislav I

    2011-01-01

    Evans s comments are related only loosely to the main body of our paper, which is devoted to the onset of void ordering: his Monte Carlo (MC) simulations of this early stage of ordering are in a qualitative agreement with our results. They question, however, the basic mechanisms of damage accumulation revealed by a number of scientists using various techniques over the years. Here we argue that his views are erroneous due to overlooking some essential features of one-dimensional defect transport.

  2. Hiro and Evans currents in Vertical Disruption Event

    NASA Astrophysics Data System (ADS)

    Zakharov, Leonid; Xujing Li Team; Sergei Galkin Team

    2014-10-01

    The notion of Tokamak Magneto-Hydrodynamics (TMHD), which explicitly reflects the anisotropy of a high temperature tokamak plasma is introduced. The set of TMHD equations is formulated for simulations of macroscopic plasma dynamics and disruptions in tokamaks. Free from the Courant restriction on the time step, this set of equations is appropriate for high performance plasmas and does not require any extension of the MHD plasma model. At the same time, TMHD requires the use of magnetic field aligned numerical grids. The TMHD model was used for creation of theory of the Wall Touching Kink and Vertical Modes (WTKM and WTVM), prediction of Hiro and Evans currents, design of an innovative diagnostics for Hiro current measurements, installed on EAST device. While Hiro currents have explained the toroidal asymmetry in the plasma current measurements in JET disruptions, the Evans currents explain the tile current measurements in tokamaks. The recently developed Vertical Disruption Code (VDE) have demonstrated 5 regimes of VDE and confirmed the generation of both Hiro and Evans currents. The results challenge the 24 years long misinterpretation of the tile currents in tokamaks as ``halo'' currents, which were a product of misuse of equilibrium reconstruction for VDE. This work is supported by US DoE Contract No. DE-AC02-09-CH1146.

  3. Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial.

    PubMed

    Welch, Martha G; Firestein, Morgan R; Austin, Judy; Hane, Amie A; Stark, Raymond I; Hofer, Myron A; Garland, Marianne; Glickstein, Sara B; Brunelli, Susan A; Ludwig, Robert J; Myers, Michael M

    2015-11-01

    Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Data were collected at 18 months corrected age from preterm infants. Infants were assigned at birth to FNI or standard care (SC). Bayley Scales of Infant Development III (Bayley-III) were assessed for 76 infants (SC, n = 31; FNI, n = 45); the Child Behavior Checklist (CBCL) for 57 infants (SC, n = 31; FNI, n = 26); and the Modified Checklist for Autism in Toddlers (M-CHAT) was obtained for 59 infants (SC, n = 33; FNI, n = 26). Family Nurture Intervention significantly improved Bayley-III cognitive (p = .039) and language (p = .008) scores for infants whose scores were greater than 85. FNI infants had fewer attention problems on the CBCL (p < .02). FNI improved total M-CHAT scores (p < .02). Seventy-six percent of SC infants failed at least one of the M-CHAT items, compared to 27% of FNI infants (p < .001). In addition, 36% of SC infants versus 0% of FNI infants failed at least one social-relatedness M-CHAT item (p < .001). Family Nurture Intervention is the first NICU intervention to show significant improvements in preterm infants across multiple domains of neurodevelopment, social-relatedness, and attention problems. These gains suggest that an intervention that facilitates emotional interactions between mothers and infants in the NICU may be key to altering developmental trajectories of preterm infants. © 2015 Association for Child and Adolescent Mental Health.

  4. Parent Experience of Neonatal Encephalopathy.

    PubMed

    Lemmon, Monica E; Donohue, Pamela K; Parkinson, Charlamaine; Northington, Frances J; Boss, Renee D

    2017-03-01

    We aimed to characterize the parent experience of caring for an infant with neonatal encephalopathy. In this mixed-methods study, we performed semistructured interviews with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. Thematic saturation was achieved after 20 interviews. Parent experience of caring for a child with neonatal encephalopathy was characterized by 3 principal themes. Theme 1: Many families described cumulative loss and grief throughout the perinatal crisis, critical neonatal course, and subsequent missed developmental milestones. Theme 2: Families experienced entangled infant and broader family interests. Theme 3: Parents evolved into and found meaning in their role as an advocate. These data offer insight into the lived experience of parenting an infant with neonatal encephalopathy. Primary data from parents can serve as a useful framework to guide the development and interpretation of parent-centered outcomes.

  5. Neonatal jaundice.

    PubMed

    McKiernan, Pat

    2012-06-01

    Neonatal jaundice lasting greater than 2 weeks should be investigated. Pale stools and dark or yellow urine are evidence of liver disease, which should be urgently investigated. The neonatal hepatitis syndrome has many causes, and a structured approach to investigation is mandatory. It should be possible to confirm or exclude biliary atresia within one week, so that definitive surgery is not delayed unnecessarily. Babies with the neonatal hepatitis syndrome should have vigorous fat-soluble vitamin supplementation, including parenteral vitamin K if coagulation is abnormal. The prognosis for infants with idiopathic neonatal hepatitis and multifactorial cholestasis is excellent.

  6. Neonatal anemia.

    PubMed

    Aher, Sanjay; Malwatkar, Kedar; Kadam, Sandeep

    2008-08-01

    Neonatal anemia and the need for red blood cell (RBC) transfusions are very common in neonatal intensive care units. Neonatal anemia can be due to blood loss, decreased RBC production, or increased destruction of erythrocytes. Physiologic anemia of the newborn and anemia of prematurity are the two most common causes of anemia in neonates. Phlebotomy losses result in much of the anemia seen in extremely low birthweight infants (ELBW). Accepting a lower threshold level for transfusion in ELBW infants can prevent these infants being exposed to multiple donors.

  7. Markedly reduced activity of mutant calcium-sensing receptor with an inserted Alu element from a kindred with familial hypocalciuric hypercalcemia and neonatal severe hyperparathyroidism.

    PubMed Central

    Bai, M; Janicic, N; Trivedi, S; Quinn, S J; Cole, D E; Brown, E M; Hendy, G N

    1997-01-01

    Missense mutations have been identified in the coding region of the extracellular calcium-sensing receptor (CASR) gene and cause human autosomal dominant hypo- and hypercalcemic disorders. The functional effects of several of these mutations have been characterized in either Xenopus laevis oocytes or in human embryonic kidney (HEK293) cells. All of the mutations that have been examined to date, however, cause single putative amino acid substitutions. In this report, we studied a mutant CASR with an Alu-repetitive element inserted at codon 876, which was identified in affected members of families with the hypercalcemic disorders, familial hypocalciuric hypercalcemia (FHH) and neonatal severe hyperparathyroidism (NSHPT), to understand how this insertion affects CASR function. After cloning of the Alu-repetitive element into the wild-type CASR cDNA, we transiently expressed the mutant receptor in HEK293 cells. Expression of mutant and wild-type receptors was assessed by Western analysis, and the effects of the mutation on extracellular calcium (Ca2+(o)) and gadolinium (Gd3+(o)) elicited increases in the cytosolic calcium concentration (Ca2+(i)) were examined in fura-2-loaded cells using dual wavelength fluorimetry. The insertion resulted in truncated receptor species that had molecular masses some 30 kD less than that of the wild-type CASR and exhibited no Ca2+(i) responses to either Ca2+(o) or Gd3+(o). A similar result was observed with a mutated CASR truncated at residue 876. However, the Alu mutant receptor had no impact on the function of the coexpressed wild-type receptor. Interestingly, the Alu mutant receptor demonstrated decreased cell surface expression relative to the wild-type receptor, whereas the CASR (A877stop) mutant exhibited increased cell surface expression. Thus, like the missense mutations that have been characterized to date in families with FHH, the Alu insertion in this family is a loss-of-function mutation that produces hypercalcemia by

  8. Neonatal teeth.

    PubMed

    Kovac, J; Kovac, D

    2011-01-01

    Teeth that are present at birth are called natal teeth, and teeth that emerge through the gingiva during the first 4 weeks of life are called neonatal teeth. The incidence of the appearance of natal and neonatal teeth has been reported to be between once every 800 and once every 6000 births. Natal and neonatal teeth may be uncomfortable for a nursing mother and present a risk of aspiration and swallowing by the infant if they are loose. Also, they may cause irritation and trauma to the infant's soft tissues. Under these circumstances, natal and neonatal teeth need to be extracted. In this article, a case report of two neonatal teeth in a five week old girl is presented. The teeth were present in the mandibular incisor region and were excessively mobile and caused discomfort for the nursing mother. They were extracted because of the fear of aspiration (Fig. 4, Ref. 10).

  9. Aldosterone regulates cellular turnover and mitogen-activated protein kinase family expression in the neonatal rat kidney.

    PubMed

    Yim, Hyung Eun; Yoo, Kee Hwan; Bae, In Sun; Jang, Gi Young; Hong, Young Sook; Lee, Joo Won

    2009-06-01

    Growing evidence indicates that aldosterone is a potent mitogenic signal regulating genes involved in antiapoptosis, cell proliferation and growth. We investigated the role of endogenous aldosterone in renal development, cell proliferation and apoptosis, and mitogen-activated protein kinase (MAPK) family expression. Newborn rats were treated with either spironolactone (200 mg/kg/d) in olive oil or only olive oil for 7 days. TUNEL assay and proliferating cell nuclear antigen (PCNA) stain were performed on kidney sections. Immunoblots, immunohistochemical (IHC) stain, and reverse transcriptase-PCR for MAPKs were performed. PCNA-positive proliferating cells decreased and apoptotic cells increased significantly with spironolactone (P < 0.05). In the spironolactone-treated group, c-jun N-terminal kinase (JNK)-2 expression increased, whereas extracellular signal regulated kinase (ERK)-2 and p38 expressions decreased in immunoblots (P < 0.05) and IHC stain. ERK-2 and p38 mRNA expressions increased in the spironolactone-treated group (P < 0.05). This study demonstrates that aldosterone blockade in the developing kidney decreases cellular proliferation, increases apoptosis, and modulates the expressions of JNK-2, ERK-2, and p38. Aldosterone possibly participates in renal development and MAPK family may serve as, in part, the signaling intermediate through the mineralocorticoid receptor (MR) in the developing kidney. J. Cell. Physiol. 219: 724-733, 2009. (c) 2009 Wiley-Liss, Inc.

  10. Is family integrated care in neonatal intensive care units feasible and good for preterm infants in China: study protocol for a cluster randomized controlled trial.

    PubMed

    Hei, Mingyan; Gao, Xiangyu; Gao, Xirong; Nong, Shaohan; Zhang, Aimin; Zhang, Qianshen; Lee, Shoo K

    2016-01-13

    By changing the paradigm of neonatal intensive care and integrating parents into the care team, the 'family integrated care' (FICare) model developed in Canada ensures that infants receive more consistent care and parents are better able to care for their infants within the neonatal intensive care unit (NICU) and at home. However, Chinese health policy dictates that parents are not allowed into the NICU during their infant's stay, which inhibits this type of parent-infant interaction and may affect infant outcomes. This project aims to demonstrate that allowing parents to care for their newborn infants in the NICU improves the medical outcomes of infants. This cluster randomized controlled trial will evaluate the feasibility and efficacy of FICare in six Chinese tertiary-level NICUs in China - three 'intervention' and three 'control' NICUs. The study steps are: (1) planning and preparation; (2) staff recruitment and training; (3) pilot study in two centers; (4) interim analysis and confirmation of sample size for main study; (5) implementation of main study; (6) data analysis and preparation and publication of study reports. The primary outcome measure is duration of hospital stay from admission to discharge. Secondary outcome measures are: (1) clinical outcomes, such as nosocomial infection, (2) weight gain, (3) breastfeeding, (4) time to full feed, and (5) maternal stress. This study will assess the feasibility and cost-effectiveness of FICare in China. By establishing that FICare is a practical model of NICU care for stable preterm infants in China, this project will have a significant impact on health outcomes, medical practice and policy, and the cost of medical care. The approach used in this project could be transferable to many other areas of medical care, such as pediatrics, chronic care, and geriatrics. Data in this project can be used to inform health policy in NICUs across China so that parents are allowed to enter the NICU and be at their infant

  11. [Effect of antepartum taurine supplementation in regulating the activity of Rho family factors and promoting the proliferation of neural stem cells in neonatal rats with fetal growth restriction].

    PubMed

    Li, Xiang-Wen; Li, Fang; Liu, Jing; Wang, Yan; Fu, Wei

    2016-11-01

    To study the possible effect of antepartum taurine supplementation in regulating the activity of Rho family factors and promoting the proliferation of neural stem cells in neonatal rats with fetal growth restriction (FGR), and to provide a basis for antepartum taurine supplementation to promote brain development in children with FGR. A total of 24 pregnant Sprague-Dawley rats were randomly divided into three groups: control, FGR, and taurine (n=8 each ). A rat model of FGR was established by food restriction throughout pregnancy. RT-PCR, immunohistochemistry, and Western blot were used to measure the expression of the specific intracellular markers for neural stem cells fatty acid binding protein 7 (FABP7), Rho-associated coiled-coil containing protein kinase 2 (ROCK2), ras homolog gene family, member A (RhoA), and Ras-related C3 botulinum toxin substrate (Rac). The FGR group had significantly lower OD value of FABP7-positive cells and mRNA and protein expression of FABP7 than the control group, and the taurine group had significantly higher OD value of FABP7-positive cells and mRNA and protein expression of FABP7 than the FGR group (P<0.05). The FGR group had significantly higher mRNA expression of RhoA and ROCK2 than the control group. The taurine group had significantly higher mRNA expression of RhoA and ROCK2 than the control group and significantly lower expression than the FGR group (P<0.05). The FGR group had significantly lower mRNA expression of Rac than the control group. The taurine group had significantly higher mRNA expression of Rac than the FGR and control groups (P<0.05). The FGR group had significantly higher protein expression of RhoA and ROCK2 than the control group. The taurine group had significantly lower protein expression of RhoA and ROCK2 than the FGR group (P<0.05). Antepartum taurine supplementation can promote the proliferation of neural stem cells in rats with FGR, and its mechanism may be related to the regulation of the activity of

  12. Neonatal medications.

    PubMed

    Ward, Robert M; Stiers, Justin; Buchi, Karen

    2015-04-01

    Neonatal abstinence syndrome (NAS) is reaching epidemic proportions related to perinatal use of opioids. There are many approaches to assess and manage NAS, including one we have outlined. A standardized approach is likely to reduce length of stay and variability in practice. Circumcision is a frequent, painful procedure performed in the neonatal period. The rationale for providing analgesia is presented as well as a review of methods. Pharmacogenomics and pharmacogenetics have expanded our understanding of diseases and their drug therapy. Some applications of pharmacogenomics to the neonatal period are presented, along with pediatric challenges of developmental expression of drug-metabolizing enzymes.

  13. Apollo 17 Astronaut Evans Retrieves Film Canister During Space Walk

    NASA Technical Reports Server (NTRS)

    1972-01-01

    In this Apollo 17 onboard photo, Command Module pilot Ronald E. Evans retrieved the film canister of the mapping cameras on the day after Apollo 17 left lunar orbit. His space walk lasted an hour. The seventh and last manned lunar landing and return to Earth mission, the Apollo 17, carrying a crew of three astronauts: Evans; Mission Commander Eugene A. Cernan; and Lunar Module pilot Harrison H. Schmitt, lifted off on December 7, 1972 from the Kennedy Space Flight Center (KSC). Scientific objectives of the Apollo 17 mission included geological surveying and sampling of materials and surface features in a preselected area of the Taurus-Littrow region, deploying and activating surface experiments, and conducting in-flight experiments and photographic tasks during lunar orbit and transearth coast (TEC). These objectives included: Deployed experiments such as the Apollo lunar surface experiment package (ALSEP) with a Heat Flow experiment, Lunar seismic profiling (LSP), Lunar surface gravimeter (LSG), Lunar atmospheric composition experiment (LACE) and Lunar ejecta and meteorites (LEAM). The mission also included Lunar Sampling and Lunar orbital experiments. Biomedical experiments included the Biostack II Experiment and the BIOCORE experiment. The mission marked the longest Apollo mission, 504 hours, and the longest lunar surface stay time, 75 hours, which allowed the astronauts to conduct an extensive geological investigation. They collected 257 pounds (117 kilograms) of lunar samples with the use of the Marshall Space Flight Center designed Lunar Roving Vehicle (LRV). The mission ended on December 19, 1972

  14. Re-development of the Mount Evans Womble Observatory

    NASA Astrophysics Data System (ADS)

    Stencel, Robert E.

    2017-01-01

    Mount Evans in the Colorado Front Range hosts one of the highest altitude observatories in the USA, at an elevation of 14,148 ft (4,312 m). The observatory is operated under a Forest Service use permit, recently renewed for another 30 years. At times, observing conditions (seeing, water vapor column, etc.) can be as good as anywhere. The existing twin 0.72 m f/21 R-C telescopes are solar powered and internet connected. However, jet stream winds in 2012 destroyed the 15 year old, 22.5 ft diameter Ash dome. The replacement, custom dome design/install was rushed, and suffers from a number of flaws. Given that, plus the aging telescope and operating system, we are planning, and seeking partners and investor funds, to re-develop the facility. Facets of this may include replacing the twin apertures with a single full-aperture telescope for remote operations and sky monitoring, replacing the flawed dome with an innovative dome design, renewable power upgrades, and outreach programs for the many thousands of mountain visitors seasonally. As elsewhere, we are grappling with increases in atmospheric water vapor and out-of-control regional light pollution growth, but believe that the site continues to hold great potential. Interested parties are invited to contact the first author for further information. Website: http://www.du.edu/~rstencel/MtEvans .

  15. Apollo 17 Astronaut Evans Retrieves Film Canister During Space Walk

    NASA Technical Reports Server (NTRS)

    1972-01-01

    In this Apollo 17 onboard photo, Command Module pilot Ronald E. Evans retrieved the film canister of the mapping cameras on the day after Apollo 17 left lunar orbit. His space walk lasted an hour. The seventh and last manned lunar landing and return to Earth mission, the Apollo 17, carrying a crew of three astronauts: Evans; Mission Commander Eugene A. Cernan; and Lunar Module pilot Harrison H. Schmitt, lifted off on December 7, 1972 from the Kennedy Space Flight Center (KSC). Scientific objectives of the Apollo 17 mission included geological surveying and sampling of materials and surface features in a preselected area of the Taurus-Littrow region, deploying and activating surface experiments, and conducting in-flight experiments and photographic tasks during lunar orbit and transearth coast (TEC). These objectives included: Deployed experiments such as the Apollo lunar surface experiment package (ALSEP) with a Heat Flow experiment, Lunar seismic profiling (LSP), Lunar surface gravimeter (LSG), Lunar atmospheric composition experiment (LACE) and Lunar ejecta and meteorites (LEAM). The mission also included Lunar Sampling and Lunar orbital experiments. Biomedical experiments included the Biostack II Experiment and the BIOCORE experiment. The mission marked the longest Apollo mission, 504 hours, and the longest lunar surface stay time, 75 hours, which allowed the astronauts to conduct an extensive geological investigation. They collected 257 pounds (117 kilograms) of lunar samples with the use of the Marshall Space Flight Center designed Lunar Roving Vehicle (LRV). The mission ended on December 19, 1972

  16. Predictors of neonatal outcomes amongst a methadone- and/or heroin-dependent population referred to a multidisciplinary Perinatal and Family Drug Health Service.

    PubMed

    Buckley, Victoria; Razaghi, Abdalvahed; Haber, Paul

    2013-10-01

    Although methadone maintenance therapy is the standard of care for opioid-dependent pregnant women, there exists controversy over the benefits and side effects of treatment to the neonate. Our aim was to document predictors of neonatal outcomes within an opioid-using population, with particular reference to methadone treatment in the context of continued heroin use. Analysis was performed on a cohort of 183 opioid-using pregnant women seen by the Sydney South West Area Health Service between 2004 and 2007 and between 2009 and 2011. Neonatal outcomes were analysed according to maternal opioid use: methadone only, methadone and heroin, or heroin only. Logistic regression was used to examine independent predictors of neonatal outcomes. No difference in the frequency of low birth weight neonates or the rate of prematurity was found between the methadone-only, methadone-and-heroin and heroin-only groups (P = 0.30; P = 0.42). Methadone treatment was not found to increase the treatment requirement for neonatal abstinence syndrome compared with those using heroin only (P = 0.91). Women using methadone only were more likely to retain custody of their child at hospital discharge than women using methadone and heroin and heroin only (80.4, 59.0, 40.0%; P < 0.001). Methadone treatment was beneficial in predicting the discharge custody status of the neonate. Engagement with antenatal care was found to reduce the likelihood of preterm birth and to be independently associated with the neonate being discharged in the care of the mother. Women who continue to use heroin should not be denied methadone treatment for fear of worse neonatal outcomes. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. Neonatal conjunctivitis

    MedlinePlus

    Newborn conjunctivitis; Conjunctivitis of the newborn; Ophthalmia neonatorum; Eye infection - neonatal conjunctivitis ... diseases spread through sexual contact to prevent newborn conjunctivitis caused by these infections. Putting eye drops into ...

  18. Neonatal magnetocardiography.

    PubMed

    Anastasiadis, P G; Anninos, P; Kotini, A; Koutlaki, N; Garas, A; Galazios, G

    2001-01-01

    The aim of the present study was to test the validity of magnetocardiography (MCG) in the estimation of neonatal cardiac rhythm using a single channel superconductive quantum interference device (SQUID). Our study population consisted of 50 neonates who were delivered normally between 37-41 weeks of gestation from clinically uncomplicated pregnancies. There was also a neonate included in the study in which the diagnosis of "hypoplastic left heart syndrome" was demonstrated by U/S Doppler examination. Maternal age ranged from 18 to 39 years (mean=29.15, SD=6.13). Our study results revealed 44 neonates with normal cardiac rhythm, four with ventricular tachycardia (VT), one with ventricular tachycardia (VT) and extrasystolic beats and one with bradycardia. The neonate with the hypoplastic left heart syndrome presented frequent episodes of ventricular bigeminy in the magnetocardiographic trace. M-mode echocardiography confirmed the diagnosis of the seven cases of arrhythmia in our study group. Results gained from the study lead us to believe that MCG could provide clinical practice with a non-invasive, rapid and easy to perform method, which could be used as an adjunct to conventional methods for the evaluation of neonatal cardiac rhythm.

  19. Tosta Evans, 1953 (Lepidoptera: Hesperiidae): a new species from northeast Brazil, first description of the female of Tosta tosta Evans, 1953, and placement of the genus within Achlyodini.

    PubMed

    Siewert, Ricardo Russo; Mielke, Olaf Hermann Hendrik; Casagrande, Mirna Martins

    2015-08-11

    A new species of Tosta Evans, 1953 from northeast Brazil is described: T. pseudospeculum Siewert, Mielke & Casagrande, sp. nov. Additionally, the female of Tosta tosta Evans, 1953, the type species of the genus, is described for the first time. Illustrations of adults and male and female genitalia for all studied species are provided, as well as a discussion of the placement of the genus within the tribe Achlyodini.

  20. 76 FR 7832 - Evans Solutions, LLC; Notice of Declaration of Intention and Soliciting Comments, Protests, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... with the Commission and is available for public inspection: a. Application Type: Declaration of Intention. b. Docket No: DI10-20-000. c. Date Filed: September 21, 2010. d. Applicant: Evans Solutions, LLC... Energy Regulatory Commission Evans Solutions, LLC; Notice of Declaration of Intention and Soliciting...

  1. Communication Challenges in Neonatal Encephalopathy.

    PubMed

    Lemmon, Monica E; Donohue, Pamela K; Parkinson, Charlamaine; Northington, Frances J; Boss, Renee D

    2016-09-01

    Families must process complex information related to neonatal encephalopathy and therapeutic hypothermia. In this mixed methods study, semi-structured interviews were performed with parents whose infants were enrolled in an existing longitudinal cohort study of therapeutic hypothermia between 2011 and 2014. Thematic saturation was achieved after 20 interviews. Parental experience of communicating with clinicians was characterized by 3 principle themes. Theme 1 highlighted that a fragmented communication process mirrored the chaotic maternal and neonatal course. Parents often received key information about neonatal encephalopathy and therapeutic hypothermia from maternal clinicians. Infant medical information was often given to 1 family member (60%), who felt burdened by the responsibility to relay that information to others. Families universally valued the role of the bedside nurse, who was perceived as the primary source of communication for most (75%) families. Theme 2 encompassed the challenges of discussing the complex therapy of therapeutic hypothermia: families appreciated clinicians who used lay language and provided written material, and they often felt overwhelmed by technical information that made it hard to understand the "big picture" of their infant's medical course. Theme 3 involved the uncertain prognosis after neonatal encephalopathy. Parents appreciated specific expectations about their infant's long-term development, and experienced long-term distress about prognostic uncertainty. Communicating complex and large volumes of information in the midst of perinatal crisis presents inherent challenges for both clinicians and families. We identified an actionable set of communication challenges that can be addressed with targeted interventions. Copyright © 2016 by the American Academy of Pediatrics.

  2. [Dermatomiositis and evans syndrome associated with HTLV-1 infection].

    PubMed

    Loja-Oropeza, David; Zavala-Flores, Ernesto; Vilca-Vasquez, Maricela

    2016-03-01

    A 55-year-old female patient, born in Ayacucho, with a history of dermatomyositis for 3 years, who received irregular treatment with prednisone. Two months prior to admission, she presented with autoinmune hemolytic anemia and idiopathic thrombocytopenic purpura. The patient received methylprednisolone pulse therapy and packed red blood cells transfusions. Upon admission, she was drowsy, with a poor overall status, marked weight loss, dehydration, with presence of livedo reticularis in her lower extremities, and onychodystrophy and onycholysis on the toes of both feet. Western blot test was positive for human T-lymphotropic virus type 1 (HTLV-1). The patient evolved with recurrent hypoglycemia. Therefore, we report a case of dermatomyositis and Evans syndrome in the context of an HTLV-1 infection.

  3. Goldin, Manley and CSA President Evans post landing

    NASA Technical Reports Server (NTRS)

    1999-01-01

    (Left to right) Canadian Minister of Industry John Manley, NASA administrator Daniel Goldin, and President of the Canadian Space Agency Mac Evans give a thumbs up to the end of a successful mission after Space Shuttle orbiter Discovery (behind them) touched down on KSC's Shuttle Landing Facility Runway 15. Main gear touchdown occurred at 2:02:43 EDT to complete the 9-day, 19- hour, 13-minute and 1-second long STS-96 mission. Onboard the Shuttle was Mission Specialist Julie Payette, who represents the Canadian Space Agency. At the controls for the landing were Commander Kent V. Rominger and Pilot Rick D. Husband. Others onboard were Mission Specialists Ellen Ochoa (Ph.D.), Tamara E. Jernigan (Ph.D.), Daniel S. Barry (M.D., Ph.D.), and Valery Ivanovich Tokarev, represents the Russian Space Agency. The crew returned from the second flight to the International Space Station on a logistics and resupply mission.

  4. The pivotal role of chelation as a stereochemical control element in non-Evans anti aldol product formation.

    PubMed

    Shinisha, C B; Sunoj, Raghavan B

    2010-06-18

    The origin of stereoselective formation of Evans syn and non-Evans anti aldol products in the reaction between titanium enolate derived from N-succinyloxazolidinone and benzaldehyde is established by using transition-state modeling. The chelated transition-state model is found to hold the key to otherwise less likely non-Evans anti aldol product, whereas the nonchelated model offers a convincing rationalization toward Evans syn aldol product. The computed results are in agreement with the reported experimental observations.

  5. Neonatal pain

    PubMed Central

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback. PMID:24330444

  6. Neonatal pain.

    PubMed

    Walker, Suellen M

    2014-01-01

    Effective management of procedural and postoperative pain in neonates is required to minimize acute physiological and behavioral distress and may also improve acute and long-term outcomes. Painful stimuli activate nociceptive pathways, from the periphery to the cortex, in neonates and behavioral responses form the basis for validated pain assessment tools. However, there is an increasing awareness of the need to not only reduce acute behavioral responses to pain in neonates, but also to protect the developing nervous system from persistent sensitization of pain pathways and potential damaging effects of altered neural activity on central nervous system development. Analgesic requirements are influenced by age-related changes in both pharmacokinetic and pharmacodynamic response, and increasing data are available to guide safe and effective dosing with opioids and paracetamol. Regional analgesic techniques provide effective perioperative analgesia, but higher complication rates in neonates emphasize the importance of monitoring and choice of the most appropriate drug and dose. There have been significant improvements in the understanding and management of neonatal pain, but additional research evidence will further reduce the need to extrapolate data from older age groups. Translation into improved clinical care will continue to depend on an integrated approach to implementation that encompasses assessment and titration against individual response, education and training, and audit and feedback.

  7. Neonatal Cholestasis

    PubMed Central

    Feldman, Amy G.; Sokol, Ronald J.

    2013-01-01

    Cholestatic jaundice is a common presenting feature of neonatal hepatobiliary and metabolic dysfunction. Any infant who remains jaundiced beyond age 2 to 3 weeks should have the serum bilirubin level fractionated into a conjugated (direct) and unconjugated (indirect) portion. Conjugated hyperbilirubinemia is never physiologic or normal. The differential diagnosis of cholestasis is extensive, and a step-wise approach based on the initial history and physical examination is useful to rapidly identify the underlying etiology. Early recognition of neonatal cholestasis is essential to ensure timely treatment and optimal prognosis. Even when specific treatment is not available, infants who have cholestasis benefit from early medical management and optimization of nutrition. Future studies are necessary to determine the most reliable and cost-effective method of universal screening for neonatal cholestasis. PMID:24244109

  8. Understanding neonatal ventilation: strategies for decision making in the NICU.

    PubMed

    Petty, Julia

    2013-01-01

    Neonatal ventilation is an integral component of care delivered in the neonatal unit. The aim of any ventilation strategy is to support the neonate's respiratory system during compromise while limiting any long-term damage to the lungs. Understanding the principles behind neonatal ventilation is essential so that health professionals caring for sick neonates and families have the necessary knowledge to understand best practice. Given the range of existing ventilation modes and parameters available, these require explanation and clarification in the context of current evidence. Many factors can influence clinical decision making on both an individual level and within the wider perspective of neonatal care.

  9. Pantoea dispersa: an unusual cause of neonatal sepsis.

    PubMed

    Mehar, Veerendra; Yadav, Dinesh; Sanghvi, Jyoti; Gupta, Nidhi; Singh, Kuldeep

    2013-01-01

    Neonatal septicemia is the most important cause of neonatal mortality. A wide variety of bacteria both aerobic and anaerobic can cause neonatal sepsis. Genus Pantoea is a member of Enterobacteriaceae family that inhabits plants, soil and water and rarely causes human infections, however, Pantoea dispersa has not been reported as a causative organism for neonatal sepsis. We hereby report two neonates with early onset sepsis caused by Pantoea dispersa. Early detection and appropriate antibiotic therapy can improve overall outcome of this rare infection in neonates. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  10. Transvascular flux and tissue accrual of Evans blue: effects of endotoxin and histamine.

    PubMed

    Green, T P; Johnson, D E; Marchessault, R P; Gatto, C W

    1988-02-01

    We investigated the relationship between the pharmacokinetics of exogenous molecules and transcapillary flux by studying the intravascular and tissue content and the histologic distribution of Evans blue in guinea pigs. Pharmacokinetic analysis demonstrated that 87% of the decline in intravascular Evans blue during the first 3 hours after administration was a result of transvascular flux to tissue compartments. Rapidly and slowly equilibrating compartments were identified. Greater than 90% of the clearances in lung and heart were rapid compartment clearances. Histologically, the distribution of Evans blue in these tissues was predominantly extracellular and similar to the distribution of fluorescein-labeled dextran. By contrast, the accumulation in kidney and liver was kinetically similar to characteristics of the slowly equilibrating compartment. This corresponded histologically to the predominant intracellular uptake of Evans blue in these tissues. Generalized increases in capillary permeability were produced by endotoxin or histamine infusion. Both treatments were associated with a more rapid initial decline in intravascular content of Evans blue than was found in control animals. Although the histologic distribution of Evans blue in tissues was not altered, endotoxin was associated with a more rapid appearance of Evans blue in the lung and heart than was seen in controls. We conclude that the initial decline in intravascular content of Evans blue corresponds to the intercompartmental clearance and to transcapillary macromolecular flux. The initial decline in serum concentrations may therefore be useful in studying disorders of generalized capillary permeability. Furthermore, the initial accrual of Evans blue in the lung and heart may be used as a marker of transcapillary macromolecular flux in those tissues.

  11. Neonatal sepsis caused by Shewanella algae: A case report.

    PubMed

    Charles, Marie Victor Pravin; Srirangaraj, Sreenivasan; Kali, Arunava

    2015-01-01

    Sepsis remains a leading cause of mortality among neonates, especially in developing countries. Most cases of neonatal sepsis are attributed to Escherichia coli and other members of the Enterobacteriaceae family. Shewanella algae (S. algae) is a gram-negative saprophytic bacillus, commonly associated with the marine environment, which has been isolated from humans. Early onset neonatal sepsis caused by S. algae is uncommon. We report a case of S. algae blood stream infection in a newborn with early onset neonatal sepsis.

  12. Neonatal sepsis

    PubMed Central

    Shah, Birju A; Padbury, James F

    2014-01-01

    Neonatal sepsis continues to be a common and significant health care burden, especially in very-low-birth-weight infants (VLBW <1500 g). Though intrapartum antibiotic prophylaxis has decreased the incidence of early-onset group B streptococcal infection dramatically, it still remains a major cause of neonatal sepsis. Moreover, some studies among VLBW preterm infants have shown an increase in early-onset sepsis caused by Escherichia coli. As the signs and symptoms of neonatal sepsis are nonspecific, early diagnosis and prompt treatment remains a challenge. There have been a myriad of studies on various diagnostic markers like hematological indices, acute phase reactants, C-reactive protein, procalcitonin, cytokines, and cell surface markers among others. Nonetheless, further research is needed to identify a biomarker with high diagnostic accuracy and validity. Some of the newer markers like inter α inhibitor proteins have shown promising results thereby potentially aiding in early detection of neonates with sepsis. In order to decrease the widespread, prolonged use of unnecessary antibiotics and improve the outcome of the infants with sepsis, reliable identification of sepsis at an earlier stage is paramount. PMID:24185532

  13. Neonatal sepsis

    MedlinePlus

    ... better the outcome. Possible Complications Complications may include: Disability Death When to Contact a Medical Professional Seek medical help right away for an infant that shows symptoms of neonatal sepsis. Prevention Pregnant women may need preventive antibiotics if they have: Chorioamnionitis ...

  14. Neonatal hematology.

    PubMed

    Diaz-Miron, Jose; Miller, Jacob; Vogel, Adam M

    2013-11-01

    Neonatal hematology is a complex and dynamic process in the pediatric population. Surgeons frequently encounter hematologic issues regarding hemostasis, inflammation, and wound healing. This publication provides a surgeon-directed review of hematopoiesis in the newborn, as well as an overview of the current understanding of their hemostatic profile under normal and pathologic conditions. © 2013 Published by Elsevier Inc.

  15. Hashimoto's thyroiditis associated Evans syndrome: A rare case report on the clustered autoimmune disease triad.

    PubMed

    Koti, Kalyan; Thumma, Rayapa Reddy; Nagarajan, Swathanthra; Mathi, Atchyuta

    2013-07-01

    Evans syndrome is a rare combination of autoimmune hemolytic anemia and immune thrombocytopenia. Their association with autoimmune thyroid diseases has been reported by few authors; however, a sequential development of the Evans syndrome in cases of Hashimoto's thyroiditis is extremely rare. The clustering of these autoimmune diseases might share a common pathogenic pathway. We present the fourth such case in world literature, of a 34-year-old female diagnosed with Hashimoto's thyroiditis in 2006, who has been taking synthetic thyroid hormone since then. Her condition is now clinically complicated with the development of the Evans syndrome.

  16. Quantification of burn induced extravasation of Evans blue albumin based on digital image analysis.

    PubMed

    Jönsson, A; Mattsson, U; Cassuto, J; Heyden, G

    1998-03-01

    The present study evaluated a non-invasive method based on digital image colour analysis that allows near-continuous quantification of extravasated Evans blue albumin after burn injury. A full-thickness burn was induced in the abdominal skin of rats, followed by injection of Evans blue dye. Tissue content of Evans blue were quantified using spectrophotometry, and compared with digital colour analysis. The non-invasive technique demonstrated a good correlation when compared to invasive spectrophotometry, but is superior by allowing near continuous measurement in the same subject and may be of value for evaluation of effective burn oedema-reducing treatment.

  17. Neonatal Infectious Diseases: Evaluation of Neonatal Sepsis

    PubMed Central

    Spearman, Paul W.; Stoll, Barbara J.

    2015-01-01

    Synopsis Neonatal sepsis remains a feared cause of morbidity and mortality in the neonatal period. Maternal, neonatal and environmental factors are associated with risk of infection, and a combination of prevention strategies, judicious neonatal evaluation and early initiation of therapy are required to prevent adverse outcomes. The following chapter reviews recent trends in epidemiology, and provides an update on risk factors, diagnostic methods and management of neonatal sepsis. PMID:23481106

  18. Neonatal infectious diseases: evaluation of neonatal sepsis.

    PubMed

    Camacho-Gonzalez, Andres; Spearman, Paul W; Stoll, Barbara J

    2013-04-01

    Neonatal sepsis remains a feared cause of morbidity and mortality in the neonatal period. Maternal, neonatal, and environmental factors are associated with risk of infection, and a combination of prevention strategies, judicious neonatal evaluation, and early initiation of therapy are required to prevent adverse outcomes. This article reviews recent trends in epidemiology and provides an update on risk factors, diagnostic methods, and management of neonatal sepsis. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Gyroxin increases blood-brain barrier permeability to Evans blue dye in mice.

    PubMed

    Alves da Silva, J A; Oliveira, K C; Camillo, M A P

    2011-01-01

    Gyroxin is a serine protease enzyme component of the South American rattlesnake (Crotalus durissus terrificus) venom. This toxin displays several activities, including the induction of blood coagulation (fibrinogenolytic activity), vasodilation and neurotoxicity, resulting in an effect called barrel rotation. The mechanisms involved in this neurotoxic activity are not well known. Because gyroxin is a member of a potentially therapeutic family of enzymes, including thrombin, ancrod, batroxobin, trypsin and kallicrein, the identification of the mechanism of gyroxin's action is extremely important. In this study, gyroxin was isolated from crude venom by affinity and molecular exclusion chromatography. Analysis of the isolated gyroxin via sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) revealed a single protein band with a molecular weight of approximately 28 kDa, confirming the identity of the molecule. Furthermore, intravenous administration of purified gyroxin (0.25 μg/g of body weight) to mice resulted in symptoms compatible with barrel rotation syndrome, confirming the neurotoxic activity of the toxin. Mice treated with gyroxin showed an increase in the concentration of albumin-Evans blue in brain extracts, indicating an increase in the blood-brain barrier (BBB) permeability. This gyroxin-induced increase in BBB permeability was time-dependent, reaching a peak within 15 min after exposure, similar to the time span in which the neurotoxic syndrome (barrel rotation) occurs. This work provides the first evidence of gyroxin's capacity to temporarily alter the permeability of the BBB.

  20. Optimization of Evans blue quantitation in limited rat tissue samples

    NASA Astrophysics Data System (ADS)

    Wang, Hwai-Lee; Lai, Ted Weita

    2014-10-01

    Evans blue dye (EBD) is an inert tracer that measures plasma volume in human subjects and vascular permeability in animal models. Quantitation of EBD can be difficult when dye concentration in the sample is limited, such as when extravasated dye is measured in the blood-brain barrier (BBB) intact brain. The procedure described here used a very small volume (30 µl) per sample replicate, which enabled high-throughput measurements of the EBD concentration based on a standard 96-well plate reader. First, ethanol ensured a consistent optic path length in each well and substantially enhanced the sensitivity of EBD fluorescence spectroscopy. Second, trichloroacetic acid (TCA) removed false-positive EBD measurements as a result of biological solutes and partially extracted EBD into the supernatant. Moreover, a 1:2 volume ratio of 50% TCA ([TCA final] = 33.3%) optimally extracted EBD from the rat plasma protein-EBD complex in vitro and in vivo, and 1:2 and 1:3 weight-volume ratios of 50% TCA optimally extracted extravasated EBD from the rat brain and liver, respectively, in vivo. This procedure is particularly useful in the detection of EBD extravasation into the BBB-intact brain, but it can also be applied to detect dye extravasation into tissues where vascular permeability is less limiting.

  1. Photoacoustic microscopy using Evans Blue dye as a contrast agent

    NASA Astrophysics Data System (ADS)

    Yao, Junjie; Maslov, Konstantin I.; Hu, Song; Wang, Lihong V.

    2010-02-01

    Complete and continuous imaging of microvascular networks is crucial for a wide variety of biomedical applications. Photoacoustic tomography can provide high resolution microvascular imaging using hemoglobin within red blood cells (RBC) as an endogenous contrast agent. However, intermittent RBC flow in capillaries results in discontinuous and fragmentary capillary images. To overcome this problem, we used Evans Blue (EB) dye as a contrast agent for in vivo photoacoustic imaging. EB has strong optical absorption at 610 nm and distributes uniformly in the blood stream by chemically binding to albumin. By intravenous injection of EB (6%, 200 μL), complete and continuous microvascular networks-especially capillaries-of the ears of nude mice were imaged. The diffusion of EB (3%, 100 μL) leaving the blood stream was monitored for 2 hours. At lower administration dose of EB (3%, 50 μL), the clearance of the EB-albumin complex was imaged for 10 days and quantitatively investigated using a two-compartment model.

  2. Optimization of Evans blue quantitation in limited rat tissue samples.

    PubMed

    Wang, Hwai-Lee; Lai, Ted Weita

    2014-10-10

    Evans blue dye (EBD) is an inert tracer that measures plasma volume in human subjects and vascular permeability in animal models. Quantitation of EBD can be difficult when dye concentration in the sample is limited, such as when extravasated dye is measured in the blood-brain barrier (BBB) intact brain. The procedure described here used a very small volume (30 µl) per sample replicate, which enabled high-throughput measurements of the EBD concentration based on a standard 96-well plate reader. First, ethanol ensured a consistent optic path length in each well and substantially enhanced the sensitivity of EBD fluorescence spectroscopy. Second, trichloroacetic acid (TCA) removed false-positive EBD measurements as a result of biological solutes and partially extracted EBD into the supernatant. Moreover, a 1:2 volume ratio of 50% TCA ([TCA final] = 33.3%) optimally extracted EBD from the rat plasma protein-EBD complex in vitro and in vivo, and 1:2 and 1:3 weight-volume ratios of 50% TCA optimally extracted extravasated EBD from the rat brain and liver, respectively, in vivo. This procedure is particularly useful in the detection of EBD extravasation into the BBB-intact brain, but it can also be applied to detect dye extravasation into tissues where vascular permeability is less limiting.

  3. Myofiber Damage Evaluation by Evans Blue Dye Injection.

    PubMed

    Wooddell, Christine I; Radley-Crabb, Hannah G; Griffin, Jacob B; Zhang, Guofeng

    2011-12-01

    Evans blue dye (EBD) can be used in live mice to study muscle pathology or injury, including exercise-induced muscle damage. EBD is excluded from intact cell membranes but leaks into cells, including muscle fibers, when the cell membrane is ruptured. EBD can be visualized by its autofluorescence under a fluorescence microscope. EBD-stained myofibers can be quantified from microscope images of muscle cross-sections. These myofibers are often in clusters that lend themselves to morphometric analysis. When the damaged myofibers are interspersed among intact myofibers, however, a more suitable approach is to count individual myofibers in the field of view. A much faster approach to measure EBD in muscles from different strains of mice or between treatment groups is to extract the EBD from muscle samples and quantitate it using a spectrophotometric microplate reader. The advantages and disadvantages of using each of these approaches are discussed here. Curr. Protoc. Mouse Biol. 1:463-488 © 2011 by John Wiley & Sons, Inc. Copyright © 2011 John Wiley & Sons, Inc.

  4. Resonance Rayleigh scattering measurement of aminoglycoside antibiotics with Evans Blue.

    PubMed

    Liu, Shao-Pu; Hu, Xiao-Li; Luo, Hong-Qun

    2003-06-01

    In a weak acid medium, some aminoglycoside antibiotics, such as kanamycin (KANA), gentamicin (GEN), tobramycin (TOB) and neomycin (NEO), or acid bisazo dye Evans Blue (EB) can only produce very weak resonance Rayleigh scattering (RRS) signals. However, when two agents react with each other to form ion-association complexes, the RRS intensity can be greatly enhanced and a new RRS spectrum with a significant enhancement of the RRS intensity in the wavelength range from 350 nm to 600 nm can be observed. The maximum scattering peak is at 570 nm. There is a linear relationship between the RRS intensity and the antibiotic concentration in the range of 0.01-6.0 microg mL(-1) at 570 nm. This RRS method for the determination of aminoglycoside antibiotics at trace-amount levels has been developed. The detection limits (3sigma) of the four antibiotics, whose order of sensitivity from high to low ranks as KANA > NEO > TOB > GEN, are 5.2-6.9 ng mL(-1). This method has good selectivity and has been successfully applied to the quick determination of antibiotics not only for injections and ear drops, but for clinic serum samples as well. In addition, the reaction mechanism by using a quantum chemistry method and the influencing factors of the RRS spectra and the enhancement reasons of RRS have been discussed.

  5. Paraneoplastic Evans syndrome in a patient with adenocarcinoma of the lung: A case report

    PubMed Central

    Yu, Hong; Fu, Rong; Wang, Huaquan; Liu, Hui

    2016-01-01

    We present a rare case of newly diagnosed Evans syndrome associated with lung papillary adenocarcinoma in which the patient showed prompt restoration of blood cell count and long‐lasting complete remission of Evans syndrome after lung cancer resection. Detailed investigation led to a diagnosis of Evans syndrome. In the first year of the disease, left lower lung papillary adenocarcinoma was diagnosed. Pulmonary lobectomy and three courses of chemotherapy were performed. Six months after the initial visit, the primary lung cancer and the autoimmune diseases appeared to be well controlled. We hypothesized that our patient's initial presentation of hematological manifestation was a paraneoplastic phenomenon associated to her underlying malignancy. This rare case report illustrates the unique relationship between primary lung cancer and the development of paraneoplastic Evans syndrome. PMID:28055149

  6. Paraneoplastic Evans syndrome in a patient with adenocarcinoma of the lung: A case report.

    PubMed

    Yu, Hong; Fu, Rong; Wang, Huaquan; Liu, Hui; Shao, Zonghong

    2017-01-01

    We present a rare case of newly diagnosed Evans syndrome associated with lung papillary adenocarcinoma in which the patient showed prompt restoration of blood cell count and long-lasting complete remission of Evans syndrome after lung cancer resection. Detailed investigation led to a diagnosis of Evans syndrome. In the first year of the disease, left lower lung papillary adenocarcinoma was diagnosed. Pulmonary lobectomy and three courses of chemotherapy were performed. Six months after the initial visit, the primary lung cancer and the autoimmune diseases appeared to be well controlled. We hypothesized that our patient's initial presentation of hematological manifestation was a paraneoplastic phenomenon associated to her underlying malignancy. This rare case report illustrates the unique relationship between primary lung cancer and the development of paraneoplastic Evans syndrome.

  7. Australian Family Research Conference Proceedings (Canberra, Australia, November 23-25, 1983). Volume I: Family Formation, Structure, Values.

    ERIC Educational Resources Information Center

    Institute of Family Studies, Melbourne (Australia).

    First in a series of seven volumes containing the proceedings of the 1983 Australian Family Research Conference, this publication deals with the formation, structure, and values of family life in Australia. Papers and authors included are: "Priorities in Family Research and Family Law" (Gareth Evans), "The Baby Boom Generation as…

  8. Australian Family Research Conference Proceedings (Canberra, Australia, November 23-25, 1983). Volume I: Family Formation, Structure, Values.

    ERIC Educational Resources Information Center

    Institute of Family Studies, Melbourne (Australia).

    First in a series of seven volumes containing the proceedings of the 1983 Australian Family Research Conference, this publication deals with the formation, structure, and values of family life in Australia. Papers and authors included are: "Priorities in Family Research and Family Law" (Gareth Evans), "The Baby Boom Generation as…

  9. Neonatal hemochromatosis.

    PubMed

    Feldman, Amy G; Whitington, Peter F

    2013-12-01

    Neonatal hemochromatosis is a clinical condition in which severe liver disease in the newborn is accompanied by extrahepatic siderosis. Gestational alloimmune liver disease (GALD) has been established as the cause of fetal liver injury resulting in nearly all cases of NH. In GALD, a women is exposed to a fetal antigen that she does not recognize as "self" and subsequently begins to produce IgG antibodies that are directed against fetal hepatocytes. These antibodies bind to fetal liver antigen and activate the terminal complement cascade resulting in hepatocyte injury and death. GALD can cause congenital cirrhosis or acute liver failure with and without iron overload and siderosis. Practitioners should consider GALD in cases of fetal demise, stillbirth, and neonatal acute liver failure. Identification of infants with GALD is important as treatment is available and effective for subsequent pregnancies.

  10. [Neonatal intussusception].

    PubMed

    Cuervo, J L

    2015-01-13

    Intussusception in infants and young children is a relatively common entity with a well defined clinical picture and a favorable outcome in most cases.The neonatal intussusceptions is extremely rare and does not have a well-defined clinical picture since its clinical manifestations vary according to the gestational time it occurs, the response of the injured intestine and the gestational age of the child concerned. Two new cases of neonatal intussusceptions are presented and a review of the world literature is performed. Given the stage of intussusceptions (pre- or postnatal) occurs and gestational age of the affected infant (preterm or term), there are three entities with clinical characteristics, topography and evolution rather different: prenatal or intrauterine intussusception, postnatal intussusception in the preterm and postnatal intussusception in the term infant.

  11. A Case of a TSH-secreting Pituitary Adenoma Associated with Evans' Syndrome.

    PubMed

    Yasuda, Atsushi; Seki, Toshiro; Oki, Masayuki; Takagi, Atsushi; Inomoto, Chie; Nakamura, Naoya; Atsumi, Hideki; Baba, Tanefumi; Matsumae, Mitsunori; Sasaki, Noriko; Suzuki, Yasuo; Fukagawa, Masafumi

    2015-06-20

    We present a case of a TSH-secreting pituitary adenoma (TSHoma) associated with Evans' syndrome. A 30-year-old woman was referred to our hospital due to purpura and ecchymoses on her limb and body and epistaxis. Evans' syndrome was diagnosed based on idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia. She had a history of malocclusion and thyroid gland enlargement 4 years prior to admission. Endocrinological tests and magnetic resonance imaging also revealed that this patient had hyperthyroidism due to the TSHoma and that this adenoma concomitantly secreted GH. Recently, several cases of Evans' syndrome were associated with hyperthyroidism caused by autoimmune thyroid disease, such as Graves' disease, suggesting that these 2 conditions may have a common immunological basis. To the best of our knowledge, there is no case report of Evans' syndrome associated with hyperthyroidism due to TSHoma. Our report suggests that the excess of thyroid hormone itself promotes autoimmunity in Evans' syndrome. Thus, early treatment for hyperthyroidism is necessary in TSHomas because of the possibility that thyroid hormone normalization may prevent the development of Evans' syndrome.

  12. Wnt family genes and their modulation in the ovary-independent and persistent vaginal epithelial cell proliferation and keratinization induced by neonatal diethylstilbestrol exposure in mice.

    PubMed

    Nakamura, Takeshi; Miyagawa, Shinichi; Katsu, Yoshinao; Watanabe, Hajime; Mizutani, Takeshi; Sato, Tomomi; Morohashi, Ken-Ichirou; Takeuchi, Takashi; Iguchi, Taisen; Ohta, Yasuhiko

    2012-06-14

    Proliferation and differentiation of cells in female reproductive organs, the oviduct, uterus and vagina, are regulated by endogenous estrogen. In utero exposure to a synthetic estrogen, diethylstilbestrol (DES), induces vaginal clear-cell adenocarcinoma in humans. In mice, perinatal exposure to DES results in abnormalities such as polyovular follicles, uterine circular muscle disorganization and persistent vaginal epithelial cell proliferation. We reported the persistent gene expression change such as interleukin-1 (IL-1) related genes, insulin-like growth factor-I (IGF-I) and its downstream signaling in the mouse vagina exposed neonatally to DES. In this study, we found persistent up-regulation of Wnt4 and persistent down-regulation of Wnt11 in the vagina of mice exposed neonatally to DES and estrogen receptor α specific ligand. Also Wnt4 expression in vagina is correlated to the stratification of epithelial cells with the superficial keratinization of vagina, but not epithelial cell stratification only.

  13. Evans blue nanocarriers visually demarcate margins of invasive gliomas.

    PubMed

    Roller, Benjamin T; Munson, Jennifer M; Brahma, Barunashish; Santangelo, Philip J; Pai, S Balakrishna; Bellamkonda, Ravi V

    2015-04-01

    Aggressive surgical resection is the primary therapy for glioma. However, aggressive resection may compromise functional healthy brain tissue. Currently, there are no objective cues for surgeons to distinguish healthy tissue from tumor and determine tumor borders; surgeons skillfully rely on subjective means such as tactile feedback. This often results in incomplete resection and recurrence. The objective of the present study was to design, develop, and evaluate, in vitro and in vivo, a nanoencapsulated visible dye for intraoperative, visual delineation of tumor margins in an invasive tumor model. Liposomal nanocarriers containing Evans blue dye (nano-EB) were developed, characterized, and tested for safety in vitro and in vivo. 3RT1RT2A glioma cells were implanted into brains of Fischer 344 rats. Nano-EB or EB solution was injected via tail vein into tumor-bearing animals. To assess tumor staining, tissue samples were analyzed visibly and using fluorescence microscopy. Area, perimeter ratios, and Manders overlap coefficients were calculated to quantify extent of staining. Nano-EB clearly marked tumor margins in the invasive tumor model. Area ratio of nano-EB staining to tumor was 0.89 ± 0.05, perimeter ratio was 0.94 ± 0.04, Manders R was 0.51 ± 0.08, and M1 was 0.97 ± 0.06. Microscopic tumor border inspection under high magnification verified that nano-EB did not stain healthy tissue. Nano-EB clearly aids in distinguishing tumor tissue from healthy tissue in an invasive tumor model, while injection of unencapsulated EB results in false identification of healthy tissue as tumor due to diffusion of dye from the tumor into healthy tissue.

  14. Gestational Mercury Vapor Exposure and Diet Contribute to Mercury Accumulation in Neonatal Rats

    PubMed Central

    Morgan, Daniel L.; Price, Herman C.; Fernando, Reshan; Chanda, Sushmita M.; O’Connor, Robert W.; Barone, Stanley S.; Herr, David W.; Beliles, Robert P.

    2006-01-01

    Exposure of pregnant Long-Evans rats to elemental mercury (Hg0) vapor resulted in a significant accumulation of Hg in tissues of neonates. Because elevated Hg in neonatal tissues may adversely affect growth and development, we were interested in how rapidly Hg was eliminated from neonatal tissues. Pregnant rats were exposed to 1, 2, or 4 mg Hg0 vapor/m3 or air (controls) for 2 hr/day from gestation day 6 (GD6) through GD15. Neonatal brain, liver, and kidney were analyzed for total Hg at various times between birth and postnatal day 90 (PND90). Milk was analyzed for Hg between birth and weaning (PND21). Before weaning, the Hg levels in neonatal tissues were proportional to maternal exposure concentrations and were highest in kidney followed by liver and then brain. There was no elimination of Hg between birth and weaning, indicating that neonates were exposed continuously to elevated levels of Hg during postpartum growth and development. Consumption of milk from exposed dams resulted in a slight increase in kidney Hg concentration during this period. Unexpectedly, neonatal Hg accumulation increased rapidly after weaning. Increased Hg was measured in both control and exposed neonates and was attributed to consumption of NIH-07 diet containing trace levels of Hg. By PND90, tissue Hg levels equilibrated at concentrations similar to those in unexposed adult Long-Evans rats fed the same diet. These data indicate that dietary exposure to trace amounts of Hg can result in a significantly greater accumulation of Hg in neonates than gestational exposure to high concentrations of Hg0 vapor. PMID:16675429

  15. The impact of preterm birth <37 weeks on parents and families: a cross-sectional study in the 2 years after discharge from the neonatal intensive care unit.

    PubMed

    Lakshmanan, Ashwini; Agni, Meghana; Lieu, Tracy; Fleegler, Eric; Kipke, Michele; Friedlich, Philippe S; McCormick, Marie C; Belfort, Mandy B

    2017-02-16

    Little is known about the quality of life of parents and families of preterm infants after discharge from the neonatal intensive care unit (NICU). Our aims were (1) to describe the impact of preterm birth on parents and families and (2) and to identify potentially modifiable determinants of parent and family impact. We surveyed 196 parents of preterm infants <24 months corrected age in 3 specialty clinics (82% response rate). Primary outcomes were: (1) the Impact on Family Scale total score; and (2) the Infant Toddler Quality of Life parent emotion and (3) time limitations scores. Potentially modifiable factors were use of community-based services, financial burdens, and health-related social problems. We estimated associations of potentially modifiable factors with outcomes, adjusting for socio-demographic and infant characteristics using linear regression. Median (inter-quartile range) infant gestational age was 28 (26-31) weeks. Higher Impact on Family scores (indicating worse effects on family functioning) were associated with taking ≥3 unpaid hours/week off from work, increased debt, financial worry, unsafe home environment and social isolation. Lower parent emotion scores (indicating greater impact on the parent) were also associated with social isolation and unpaid time off from work. Lower parent time limitations scores were associated with social isolation, unpaid time off from work, financial worry, and an unsafe home environment. In contrast, higher parent time limitations scores (indicating less impact) were associated with enrollment in early intervention and Medicaid. Interventions to reduce social isolation, lessen financial burden, improve home safety, and increase enrollment in early intervention and Medicaid all have the potential to lessen the impact of preterm birth on parents and families.

  16. Neonatal Hemophilia: A Rare Presentation

    PubMed Central

    Proença, Elisa; Godinho, Cristina; Oliveira, Dulce; Guedes, Ana; Morais, Sara; Carvalho, Carmen

    2015-01-01

    Hemophilia A is a X-linked hereditary condition that lead to decreased factor VIII activity, occurs mainly in males. Decreased factor VIII activity leads to increased risk of bleeding events. During neonatal period, diagnosis is made after post-partum bleeding complication or unexpected bleeding after medical procedures. Subgaleal hemorrhage during neonatal period is a rare, severe extracranial bleeding with high mortality and usually related to traumatic labor or coagulation disorders. Subgaleal hemorrhage complications result from massive bleeding. We present a neonate with unremarkable family history and uneventful pregnancy with a vaginal delivery with no instrumentation, presenting with severe subgaleal bleeding at 52 hours of life. Aggressive support measures were implemented and bleeding managed. The unexpected bleeding lead to a coagulation study and the diagnosis of severe hemophilia A. There were no known sequelae. This case shows a rare hemophilia presentation reflecting the importance of coagulation studies when faced with unexplained severe bleeding. PMID:26734126

  17. The tissue distribution of Evans blue dye in a sheep model of sentinel node biopsy.

    PubMed

    Green, Michael; Farshid, Gelareh; Kollias, James; Chatterton, Barry E; Tsopelas, Chris

    2006-09-01

    Tc-Evans blue is a 'single dose' agent for lymphatic mapping combining radioactivity and blue dye for sentinel node identification. The mechanism and distribution of blue dye retention in the lymph node is not clearly understood. To demonstrate the cellular distribution of Tc-Evans blue in sheep sentinel lymph nodes by measuring the radioactivity of different tissue components and correlating this with pathological examination. Tc-Evans blue was used to identify sheep lymph nodes. Part of each node was sent for pathological examination including imprint cytology, and frozen and permanent section examination. Sections were examined without stains, with only red stains and conventional haematoxylin & eosin staining. The remaining nodal tissue was homogenized and components separated by enzymatic digestion and density gradient centrifugation. Fractions representing each tissue component were counted in a gamma counter and the distribution of Tc-Evans blue calculated. A dispersed population of blue staining cells was found. Their distribution, number and size indicated that they were histiocytes such as macrophages or antigen presenting cells. Radioactivity was distributed throughout the lymph node. Over 70% remained in the plasma, 19% in the leukocyte layer, and 10% was associated with erythrocytes and undigested tissue. The accumulation of radioactivity and blue colour in the lymph nodes indicates the mechanism of retention is a result of the binding interaction between Tc-Evans blue-protein and lymph node histiocytes including macrophages and antigen presenting cells.

  18. Enhancement of Ca2+-dependent outward current in sheep bladder myocytes by evans blue dye.

    PubMed

    Hollywood, M A; Cotton, K D; McHale, N G; Thornbury, K D

    1998-04-01

    Whole-cell and inside-out patch-clamp techniques were used to assess the action of a well-known dye, Evans blue, on membrane currents in bladder isolated smooth muscle cells from sheep. In whole cells Evans blue dose-dependently increased the outward current by up to fivefold. In contrast, Evans blue had no effect on inward Ca2+ current. The effect on outward current was abolished or reduced if the cells were bathed in Ca2+-free solution, iberiotoxin (5 x 10(-8) M), or charybdotoxin (5 x 10(-8) M), but was unaffected by externally applied caffeine (5 mM) or in cells exposed to heparin (1 mg/ml) via the patch pipette. In inside-out patches bathed in a Ca2+ concentration of 5 x 10(-7) M, Evans blue (10(-4) M) increased the open probability of large-conductance (298-pS) Ca2+-dependent K+ channels (BK channels), shifting the half maximal-activation voltage by -70 mV. We conclude that Evans blue dye acts as an opener of BK channels.

  19. Plasma volume estimation in severely ill infants and children using a simplified Evans blue method.

    PubMed

    Linderkamp, O; Mader, T; Butenandt, O; Riegel, K P

    1977-06-01

    Plasma volume was measured using Evans blue dye and 125iodinated human serum albumin (RIHSA) simultaneously in order to evaluate the accuracy of a simplified Evans blue method recommended by Nielsen and Nielsen (1962). 9 studies were performed in 8 newborn infants weighing 1.07 to 2.85 kg and 16 studies in 14 patients aged 6 months to 14 years suffering from severe circulatory disturbances. In 20 studies, plasma volumes measured by Evans blue and by RIHSA agreed within +/-5%, and in all the studies within +/-10%. The Evans blue method yielded higher plasma volumes than the RIHSA method in 19 instances. The mean difference (paired t-test) was only significant in newborn infants (+4.0+/-3.6%; P less than 0.05). The disappearance rates of Evans blue exceeded that of RIHSA in 16 studies, but this was only significant in the patients older than 6 months (+2.3+/-4.2%/h; P less than 0.05).

  20. Neonatal resuscitation: Current issues

    PubMed Central

    Chadha, Indu A

    2010-01-01

    The following guidelines are intended for practitioners responsible for resuscitating neonates. They apply primarily to neonates undergoing transition from intrauterine to extrauterine life. The updated guidelines on Neonatal Resuscitation have assimilated the latest evidence in neonatal resuscitation. Important changes with regard to the old guidelines and recommendations for daily practice are provided. Current controversial issues concerning neonatal resuscitation are reviewed and argued in the context of the ILCOR 2005 consensus. PMID:21189881

  1. Neonatal lupus.

    PubMed

    Robles, David T; Jaramillo, Lorena; Hornung, Robin L

    2006-12-10

    An otherwise healthy 5-week-old infant with erythematous plaques predominantly on the face and scalp presented to our dermatology clinic. The mother had been diagnosed with lupus erythematosus 2 years earlier but her disease was quiescent. Neonatal lupus is a rare condition associated with transplacental transfer of IgG anti-SSA/Ro and anti-SSB/La antibodies from the mother to the fetus. Active connective tissue disease in the mother does not have to be present and in fact is often absent. Although the cutaneous, hematologic and hepatic manifestations are transient, the potential for permanent heart block makes it necessary for this to be carefully ruled out. As in this case, the dermatologist may be the one to make the diagnosis and should be aware of the clinical presentation, work-up, and management of this important disease.

  2. An improved method for the determination of the plasma volume with Evans Blue.

    PubMed

    Zweens, J; Frankena, H

    1981-09-01

    A new method for the spectrophotometric determination of Evans Blue in plasma is presented. The method is based on the precipitation of the non-albumin fraction of the plasma proteins with polyethylene glycol, in order to eliminate the variable background absorption of plasma at the wavelength of maximum absorbance of Evans Blue. The accuracy and precision of the method is excellent: at an Evans Blue concentration in plasma of 5 mg . 1(-1) the coefficient of variation of the method is less than 1%. Five different procedures currently in use for the calculation of the plasma volume from the amount of indicator injected and the concentration at zero time (c0) were compared. Extrapolation to zero time of the early part (10 to 60 min) of the log concentration vs time curve turned out to the the best method for the calculation of c0, and hence yields the best estimate of the plasma volume.

  3. Modified Evans peroneus brevis lateral ankle stabilization for balancing varus ankle contracture during total ankle replacement.

    PubMed

    Roukis, Thomas S

    2013-01-01

    Lateral ankle instability is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, I have described a modification of the Evans peroneus brevis tendon lateral ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis is then transferred either to the anterior distal tibia concomitantly with total ankle replacement or through the tibia when performed after total ankle replacement and secured with plate and screw fixation. This modified Evans peroneus brevis tendon is useful in providing lateral ankle stability during or after primary and revision total ankle replacement.

  4. Monotypic no longer: a new species of Panca Evans (Lepidoptera: Hesperiidae: Hesperiinae: Moncini) from South America.

    PubMed

    Dolibaina, Diego Rodrigo; Carneiro, Eduardo; Mielke, Olaf Hermann Hendrik; Casagrande, Mirna Martins; Lamas, Gerardo

    2017-05-19

    A new species belonging to the previously monotypic genus Panca Evans, 1955, P. moseri Dolibaina, Carneiro & O. Mielke sp. nov., from grasslands areas of Peru, Bolivia and Brazil is described. Adults and male and female genitalia of the new species are illustrated, described in detail, and compared with the type species of the genus, Lerodea subpunctuli Hayward, 1934, and with its externally most similar and sympatric species, Vidius mictra Evans, 1955. The systematic position of the genus Panca and its association with lowland open natural habitats of South America are discussed.

  5. [The Evans case and the right not to be forced to reproduce].

    PubMed

    Alkorta Idiakez, Itziar

    2006-01-01

    The article analyses the ruling of the European Court of Human Rights, Evans v. United Kingdom, of March 7, 2006 (application no. 6339/05) from the perspective of the nature and the effects of a consent together with the conservation and disposal of cryopreserved embryos. Several prevailing normative models are studied in order to look at the disposal of embryos and to test its legal consistency. As a conclusion and basing it on the Evans case, there is a proposition to distinguish between the acts of disposal of spare embryos from IVF programs and the deposit of embryos as a way to prevent lack of fertility.

  6. Outcome following neonatal seizures.

    PubMed

    Uria-Avellanal, Cristina; Marlow, Neil; Rennie, Janet M

    2013-08-01

    Neonatal seizures are the most common manifestation of neurological disorders in the newborn period and an important determinant of outcome. Overall, for babies born at full term, mortality following seizures has improved in the last decade, typical current mortality rates being 10% (range: 7-16%), down from 33% in reports from the 1990s. By contrast, the prevalence of adverse neurodevelopmental sequelae remains relatively stable, typically 46% (range: 27-55%). The strongest predictors of outcome are the underlying cause, together with the background electroencephalographic activity. In preterm babies, for whom the outlook tends to be worse as background mortality and disability are high, seizures are frequently associated with serious underlying brain injury and therefore subsequent impairments. When attempting to define the prognosis for a baby with neonatal seizures, we propose a pathway involving history, examination, and careful consideration of all available results (ideally including brain magnetic resonance imaging) and the response to treatment before synthesizing the best estimate of risk to be conveyed to the family. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. In vivo and in vitro characterization of neonatal hyperparathyroidism resulting from a de novo, heterozygous mutation in the Ca2+-sensing receptor gene: normal maternal calcium homeostasis as a cause of secondary hyperparathyroidism in familial benign hypocalciuric hypercalcemia.

    PubMed Central

    Bai, M; Pearce, S H; Kifor, O; Trivedi, S; Stauffer, U G; Thakker, R V; Brown, E M; Steinmann, B

    1997-01-01

    We characterized the in vivo, cellular and molecular pathophysiology of a case of neonatal hyperparathyroidism (NHPT) resulting from a de novo, heterozygous missense mutation in the gene for the extracellular Ca2+ (Ca2+(o))-sensing receptor (CaR). The female neonate presented with moderately severe hypercalcemia, markedly undermineralized bones, and multiple metaphyseal fractures. Subtotal parathyroidectomy was performed at 6 wk; hypercalcemia recurred rapidly but the bone disease improved gradually with reversion to an asymptomatic state resembling familial benign hypocalciuric hypercalcemia (FBHH). Dispersed parathyroid cells from the resected tissue showed a set-point (the level of Ca2+(o) half maximally inhibiting PTH secretion) substantially higher than for normal human parathyroid cells (approximately 1.8 vs. approximately 1.0 mM, respectively); a similar increase in set-point was observed in vivo. The proband's CaR gene showed a missense mutation (R185Q) at codon 185, while her normocalcemic parents were homozygous for wild type (WT) CaR sequence. Transient expression of the mutant R185Q CaR in human embryonic kidney (HEK293) cells revealed a substantially attenuated Ca2+(o)-evoked accumulation of total inositol phosphates (IP), while cotransfection of normal and mutant receptors showed an EC50 (the level of Ca2+(o) eliciting a half-maximal increase in IPs) 37% higher than for WT CaR alone (6.3+/-0.4 vs. 4.6+/-0.3 mM Ca2+(o), respectively). Thus this de novo, heterozygous CaR mutation may exert a dominant negative action on the normal CaR, producing NHPT and more severe hypercalcemia than typically seen with FBHH. Moreover, normal maternal calcium homeostasis promoted additional secondary hyperparathyroidism in the fetus, contributing to the severity of the NHPT in this case with FBHH. PMID:9011580

  8. Neonatal euthanasia.

    PubMed

    Kon, Alexander A

    2009-12-01

    Despite advances in the care of infants, there remain many newborns whose medical conditions are incompatible with sustained life. At times, healthcare providers and parents may agree that prolonging life is not an appropriate goal of care, and they may redirect treatment to alleviate suffering. While pediatric palliative treatment protocols are gaining greater acceptance, there remain some children whose suffering is unrelenting despite maximal efforts. Due to the realization that some infants suffer unbearably (ie, the burdens of suffering outweigh the benefits of life), the Dutch have developed a protocol for euthanizing these newborns. In this review, I examine the ethical aspects of 6 forms of end of life care, explain the ethical arguments in support of euthanasia, review the history and verbiage of the United States regulations governing limiting and withdrawing life-prolonging interventions in infants, describe the 3 categories of neonates for whom the Dutch provide euthanasia, review the published analyses of the Dutch protocol, and finally present some practical considerations should some form of euthanasia ever be deemed appropriate.

  9. [Neonatal resuscitation].

    PubMed

    Burón Martínez, E; Aguayo Maldonado, J

    2006-11-01

    At birth approximately 10 % of term or near-term neonates require initial stabilization maneuvers to establish a cry or regular breathing, maintain a heart rate greater than 100 beats per minute (bpm), and good color and muscular tone. About 1 % requires ventilation and very few infants receive chest compressions or medication. However, birth asphyxia is a worldwide problem and can lead to death or serious sequelae. Recently, the European Resuscitation Council (ERC) and the International Liaison Committee on Resuscitation (ILCOR) published new guidelines on resuscitation at birth. These guidelines review specific questions such as the use of air or 100 % oxygen in the delivery room, dose and routes of adrenaline delivery, the peripartum management of meconium-stained amniotic fluid, and temperature control. Assisted ventilation in preterm infants is briefly described. New devices to improve the care of newborn infants, such as the laryngeal mask airway or CO2 detectors to confirm tracheal tube placement, are also discussed. Significant changes have occurred in some practices and are included in this document.

  10. POSTNATAL DISPOSITION OF TCDD IN LONG EVANS RATS FOLLOWING GESTATIONAL EXPOSURE

    EPA Science Inventory

    POSTNATAL DISPOSITION OF TCDD IN LONG EVANS RATS FOLLOWING GESTATIONAL EXPOSURE.
    J J Diliberto', J T Hamm'.2, F McQuaid', and L S Birnbaum'. 'US EPA, ORD/NHEERL/ETD, RTP, NC; 2Curriculum in Toxicology, University of North Carolina, Chapel Hill, NC.
    2,3,7,8-Tetrachlorodibenz...

  11. Academic Writing in Context: Implications and Applications. Papers in Honour of Tony Dudley-Evans.

    ERIC Educational Resources Information Center

    Hewings, Martin, Ed.

    The papers in this volume were collected to honor T. Dudley-Evans on his retirement from the University of Birmingham. They explore a number of themes of current interest to those engaged in English language teaching and academic writing. The papers are: (1) Introduction (Martin Hewings); (2) Distance and Refined Selves: Educational Tensions in…

  12. ADVERSE EFFECTS OF TCDD ON MAMMARY GLAND DEVELOPMENT IN LONG EVANS RATS: A TWO GENERATIONAL STUDY

    EPA Science Inventory

    Recent studies have demonstrated variable effects on mammary gland development in rat offspring exposed to TCDD (2,3,7,8-tetrachlorodibenzo-p-dioxin, 1 ug/kg, gavage) on day 15 of gestation. We have characterized these effects in Long Evans rats, in both one and two-generational...

  13. BROMATE-INDUCED TRANSCRIPTIONAL CHANGES IN LONG-EVANS RAT KIDNEYS

    EPA Science Inventory


    Bromate-Induced Transcriptional Changes in Long-Evans Rat Kidneys.

    Ozone disinfection of surface waters containing bromide ion (Br-) results in the oxidation of bromide to bromate, which can be found in finished drinking water as a by-product. Potassium bromate (KBrO3)...

  14. EVALUATION OF FERTILIZATION FOLLOWING OVULATORY DELAY WITH THIRAM IN THE LONG-EVANS HOODED RAT

    EPA Science Inventory

    Evaluation of fertilization following ovulatory delay with thiram in the Long-Evans Hooded Rat

    1TE Stoker, 1* S Jeffay, and 1 SD Perreault.

    1Gamete and Early Embryogenesis Biology Branch and 2 Endocrinology Branch, Reproductive Toxicology Division, NHEERL, US EPA, R...

  15. BROMATE-INDUCED TRANSCRIPTIONAL CHANGES IN LONG-EVANS RAT KIDNEYS

    EPA Science Inventory


    Bromate-Induced Transcriptional Changes in Long-Evans Rat Kidneys.

    Ozone disinfection of surface waters containing bromide ion (Br-) results in the oxidation of bromide to bromate, which can be found in finished drinking water as a by-product. Potassium bromate (KBrO3)...

  16. Academic Writing in Context: Implications and Applications. Papers in Honour of Tony Dudley-Evans.

    ERIC Educational Resources Information Center

    Hewings, Martin, Ed.

    The papers in this volume were collected to honor T. Dudley-Evans on his retirement from the University of Birmingham. They explore a number of themes of current interest to those engaged in English language teaching and academic writing. The papers are: (1) Introduction (Martin Hewings); (2) Distance and Refined Selves: Educational Tensions in…

  17. The conformational characteristics of Congo red, Evans blue and Trypan blue.

    PubMed

    Skowronek, M; Roterman; Konieczny, L; Stopa, B; Rybarska, J; Piekarska, B; Górecki, A; Król, M

    2000-05-01

    The structures of the closely related bis-azo dyes Evans blue, Trypan blue and Congo red, which appeared to have different self-assembly properties and correspondingly different abilities to form complexes with amyloids and some other proteins, were compared in this work. Ab initio and semi-empirical methods were used to find the optimal structures and partial charge distributions of the dyes. The optimal structures were searched using different widely used programs. The structures of Congo red and evans blue were found to be planar, except for the torsion on the central diphenyl bond connecting the two halves of the dye. Both symmetrical parts of the molecules appeared very close to planarity. However, Trypan blue exhibits non planarity on the di-azo bonds, as well as on the central bond between the symmetrical parts of the dye. In a consequence, the non planarity of this molecule is higher than in the case of its isomer, Evans blue and Congo red as well. The extra rotation around the azo bonds extorted by the close proximity of the sulfonic groups may be the direct cause of its poor self-assembling and complexation properties versus Evans blue.

  18. EVALUATION OF FERTILIZATION FOLLOWING OVULATORY DELAY WITH THIRAM IN THE LONG-EVANS HOODED RAT

    EPA Science Inventory

    Evaluation of fertilization following ovulatory delay with thiram in the Long-Evans Hooded Rat

    1TE Stoker, 1* S Jeffay, and 1 SD Perreault.

    1Gamete and Early Embryogenesis Biology Branch and 2 Endocrinology Branch, Reproductive Toxicology Division, NHEERL, US EPA, R...

  19. DEVELOPMENTAL EFFECTS OF TRICHLOROACETONITRILE ADMINISTERED IN CORN OIL TO PREGNANT LONG-EVANS RATS

    EPA Science Inventory

    Trichloroacetonitrile (TCAN) is a by-product of the chlorine disinfection of water containing natural organic material. When administered by gavage to pregnant Long-Evans rats in a medium-chain triglyceride vehicle, tricaprylin oil (Tricap), at a volume of 10 ml/kg, TCAN induced ...

  20. Predatory Odor Disrupts Social Novelty Preference in Long-Evans Rats

    ERIC Educational Resources Information Center

    Anderson, Matthew J.; Layton, William B.

    2012-01-01

    The present study examined the effects of predatory odor (cat urine) on social novelty preference in Long-Evans rats. Adult male subjects encountered a juvenile conspecific at training, were exposed to either clean cat litter (control) or litter soiled with cat urine (predatory odor), and were tested for social novelty preference. While the…

  1. Sows' Ears and Silk Purses: A Rejoinder to Evans and Saxe.

    ERIC Educational Resources Information Center

    Grant, S. G.; Tzetzo, Kathryn

    1998-01-01

    Relates questions that the authors' asked when reviewing Ronald Evans and David Saxe's "Handbook on Teaching Social Education." Extends points from the original review: (1) the "Handbook" sends mixed messages about the nature of issues-centered teaching; and (2) it leaves unanswered questions concerning the relationship between…

  2. Determinants of neonatal mortality in central Sudan.

    PubMed

    Taha, T E; Gray, R H; Abdelwahab, M M

    1993-01-01

    A follow-up study was conducted in six community health centres during the period April 1989 to March 1990 to determine the risk factors which influence neonatal survival in central Sudan. The estimated neonatal mortality rate ranged between 20.0 and 36.0 per 1000 live births per year, and the major cause of death was tetanus neonatorum (29% of neonatal deaths). The mortality rate was lowest when tetanus toxoid was received during pregnancy and the umbilical cord was cleaned by a modern hygienic method (mortality rate of 11 per 1000). In contrast, the mortality rate was highest when no tetanus toxoid was received and no or traditional cord cleaning was used (mortality rate of 62 per 1000; relative risk (RR) = 5.6, 95% confidence interval (CI) 2.0-14.9). The major predictors of neonatal mortality were tetanus, short birth-to-conception interval, multiparity, reported malaria during pregnancy, low birthweight, low maternal weight and low socio-economic status. The population attributable risks were high, and the preventable factors collectively accounted for 93.5% of neonatal mortality. Safe deliveries and wider immunization coverage are needed to control neonatal tetanus in this community. Other interventions to lower neonatal mortality in central Sudan should include accessible family planning programmes and measures to lower the incidence of low birthweight.

  3. Water immersion in neonatal bereavement photography.

    PubMed

    Duffey, Heather

    2014-01-01

    Water immersion in neonatal bereavement photography is a new technique intended to enhance the quality of the photographs provided to families following their loss. Water immersion appears to be most helpful following a second trimester fetal demise. This technique can be used by nurses, professional photographers and others in addition to more traditional neonatal bereavement photography. It does not require special skills or equipment and can be implemented in virtually any perinatal setting. The enhanced quality of photographs produced with this method can potentially provide a source of comfort to grieving families. © 2014 AWHONN.

  4. Anaerobic testing using the Wingate and Evans-Quinney protocols with and without toe stirrups.

    PubMed

    LaVoie, N; Dallaire, J; Brayne, S; Barrett, D

    1984-03-01

    Recently, considerable attention has been focused on the measurement of maximal anaerobic power. The Evans-Quinney (1981) protocol which considers leg volume as well as body weight in establishing optimal load settings on the bicycle ergometer has been shown to result in significantly higher anaerobic power outputs than the body weight-relative Wingate protocol. The purpose of this investigation was to compare the anaerobic power outputs during bicycle ergometer work using the Wingate and Evans-Quinney protocols with and without toe stirrups. Fifty male physical education and varsity athletes (average age 22.6 years) volunteered to participate in this experiment. All subjects performed a total of four maximal 30-second anaerobic power tests utilizing the force settings established by the Wingate (load [L] = 0.075 kp/kg body weight) and Evans-Quinney (L = -0.4914-0.2151 (weight, kg) + 2.1124 (leg volume, litre) protocol. The subjects were randomly assigned to one of four counterbalanced orders of test administration. Analysis of data indicated significant differences (P less than or equal to .05) among the variables of: 5-second peak power (W), 30-second anaerobic capacity (W) and percent fatigue as a function of test protocol. Significantly higher values were obtained for all variables under the Evans-Quinney test procedure using toe stirrups while the Wingate test procedure without toe stirrups showed significantly lower values for all variables. It was concluded that the Evans-Quinney load setting protocol with toe stirrups resulted in significantly higher power measures than any of the other treatments tested.

  5. Neonatal euthanasia: moral considerations and criminal liability.

    PubMed

    Sklansky, M

    2001-02-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice.

  6. Idiopathic Neonatal Colonic Perforation

    PubMed Central

    Tuncer, Oğuz; Melek, Mehmet; Kaba, Sultan; Bulan, Keziban; Peker, Erdal

    2014-01-01

    Though the perforation of the colon in neonates is rare, it is associated with more than 50% mortality in high-risk patients. We report a case of idiopathic neonatal perforation of the sigmoid colon in an 8-day-old, healthy, male neonate without any demonstrable cause. PMID:26023477

  7. Neonatal Acute Kidney Injury.

    PubMed

    Selewski, David T; Charlton, Jennifer R; Jetton, Jennifer G; Guillet, Ronnie; Mhanna, Maroun J; Askenazi, David J; Kent, Alison L

    2015-08-01

    In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on outcomes across medicine. Research based on single-center cohorts suggests that neonatal AKI is very common and associated with poor outcomes. In this state-of-the-art review on neonatal AKI, we highlight the unique aspects of neonatal renal physiology, definition, risk factors, epidemiology, outcomes, evaluation, and management of AKI in neonates. The changes in renal function with gestational and chronologic age are described. We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the rationale for its use as the standardized definition of neonatal AKI. We discuss risk factors for neonatal AKI and suggest which patient populations may warrant closer surveillance, including neonates <1500 g, infants who experience perinatal asphyxia, near term/ term infants with low Apgar scores, those treated with extracorporeal membrane oxygenation, and those requiring cardiac surgery. We provide recommendations for the evaluation and treatment of these patients, including medications and renal replacement therapies. We discuss the need for long-term follow-up of neonates with AKI to identify those children who will go on to develop chronic kidney disease. This review highlights the deficits in our understanding of neonatal AKI that require further investigation. In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better understanding neonatal AKI, beginning to answer critical questions, and improving outcomes in these vulnerable populations.

  8. Neonatal hypoglycaemia: learning from claims

    PubMed Central

    Hawdon, Jane M; Beer, Jeanette; Sharp, Deborah; Upton, Michele

    2017-01-01

    Objectives Neonatal hypoglycaemia is a potential cause of neonatal morbidity, and on rare but tragic occasions causes long-term neurodevelopmental harm with consequent emotional and practical costs for the family. The organisational cost to the NHS includes the cost of successful litigation claims. The purpose of the review was to identify themes that could alert clinicians to common pitfalls and thus improve patient safety. Design The NHS Litigation Authority (NHS LA) Claims Management System was reviewed to identify and review 30 claims for injury secondary to neonatal hypoglycaemia, which were notified to the NHS LA between 2002 and 2011. Setting NHS LA. Patients Anonymised documentation relating to 30 neonates for whom claims were made relating to neonatal hypoglycaemia. Dates of birth were between 1995 and 2010. Interventions Review of documentation held on the NHS LA database. Main outcome measures Identifiable risk factors for hypoglycaemia, presenting clinical signs, possible deficits in care, financial costs of litigation. Results All claims related to babies of at least 36 weeks’ gestation. The most common risk factor for hypoglycaemia was low birth weight or borderline low birth weight, and the most common reported presenting sign was abnormal feeding behaviour. A number of likely deficits in care were reported, all of which were avoidable. In this 10-year reporting period, there were 25 claims for which damages were paid, with a total financial cost of claims to the NHS of £162 166 677. Conclusions Acknowledging that these are likely to be the most rare but most seriously affected cases, the clinical themes arising from these cases should be used for further development of training and guidance to reduce harm and redivert NHS funds from litigation to direct care. PMID:27553590

  9. Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study.

    PubMed

    Dellenmark-Blom, Michaela; Wigert, Helena

    2014-03-01

    A descriptive study of parents' experiences with neonatal home care following initial care in the neonatal intensive care unit. As survival rates improve among premature and critically ill infants with an increased risk of morbidity, parents' responsibilities for neonatal care grow in scope and degree under the banner of family-centred care. Concurrent with medical advances, new questions arise about the role of parents and the experience of being provided neonatal care at home. An interview study with a phenomenological hermeneutic approach. Parents from a Swedish neonatal (n = 22) home care setting were extensively interviewed within one year of discharge. Data were collected during 2011-2012. The main theme of the findings is that parents experience neonatal home care as an inner emotional journey, from having a child to being a parent. This finding derives from three themes: the parents' experience of leaving the hospital milieu in favour of establishing independent parenthood, maturing as a parent and processing experiences during the period of neonatal intensive care. This study suggests that neonatal home care is experienced as a care structure adjusted to incorporate parents' needs following discharge from a neonatal intensive care unit. Neonatal home care appears to bridge the gap between hospital and home, supporting the family's adaptation to life in the home setting. Parents become empowered to be primary caregivers, having nurse consultants serving the needs of the whole family. Neonatal home care may therefore be understood as the implementation of family-centred care during the transition from NICU to home. © 2013 John Wiley & Sons Ltd.

  10. X-linked mental retardation with neonatal hypotonia in a French family (MRX15): gene assignment to Xp11.22-Xp21.1.

    PubMed

    Raynaud, M; Gendrot, C; Dessay, B; Moncla, A; Ayrault, A D; Moizard, M P; Toutain, A; Briault, S; Villard, L; Ronce, N; Moraine, C

    1996-07-12

    Linkage analysis was performed in a family with non-specific X-linked mental retardation (MRX 15). Hypotonia in infancy was the most remarkable physical manifestation. The severity of mental deficiency was variable among the patients, but all of them had poor or absent speech. Significant lod scores at a recombination fraction of zero were detected with the marker loci DXS1126, DXS255, and DXS573 (Zmax = 2.01) and recombination was observed with the two flanking loci DXS164 (Xp21.1) and DXS988 (Xp11.22), identifying a 17 cM interval. This result suggests a new gene localization in the proximal Xp region. In numerous families with non-specific X-linked mental retardation (MRX), the corresponding gene has been localized to the paracentromeric region in which a low recombination rate impairs the precision of mapping.

  11. X-linked mental retardation with neonatal hypotonia in a French family (MRX15): Gene assignment to Xp11.22-Xp21.1

    SciTech Connect

    Raynaud, M.; Dessay, B.; Ayrault, A.D.

    1996-07-12

    Linkage analysis was performed in a family with non-specific X-linked mental retardation (MRX 15). Hypotonia in infancy was the most remarkable physical manifestation. The severity of mental deficiency was variable among the patients, but all of them had poor or absent speech. Significant lod scores at a recombination fraction of zero were detected with the marker loci DXS1126, DXS255, and DXS573 (Zmax = 2.01) and recombination was observed with the two flanking loci DXS164 (Xp21.1) and DXS988 (Xp11.22), identifying a 17 cM interval. This result suggests a new gene localization in the proximal Xp region. In numerous families with non-specific X-linked mental retardation (MRX), the corresponding gene has been localized to the paracentromeric region in which a low recombination rate impairs the precision of mapping. 58 refs., 3 figs., 5 tabs.

  12. Automated method to compute Evans index for diagnosis of idiopathic normal pressure hydrocephalus on brain CT images

    NASA Astrophysics Data System (ADS)

    Takahashi, Noriyuki; Kinoshita, Toshibumi; Ohmura, Tomomi; Matsuyama, Eri; Toyoshima, Hideto

    2017-03-01

    The early diagnosis of idiopathic normal pressure hydrocephalus (iNPH) considered as a treatable dementia is important. The iNPH causes enlargement of lateral ventricles (LVs). The degree of the enlargement of the LVs on CT or MR images is evaluated by using a diagnostic imaging criterion, Evans index. Evans index is defined as the ratio of the maximal width of frontal horns (FH) of the LVs to the maximal width of the inner skull (IS). Evans index is the most commonly used parameter for the evaluation of ventricular enlargement. However, manual measurement of Evans index is a time-consuming process. In this study, we present an automated method to compute Evans index on brain CT images. The algorithm of the method consisted of five major steps: standardization of CT data to an atlas, extraction of FH and IS regions, the search for the outmost points of bilateral FH regions, determination of the maximal widths of both the FH and the IS, and calculation of Evans index. The standardization to the atlas was performed by using linear affine transformation and non-linear wrapping techniques. The FH regions were segmented by using a three dimensional region growing technique. This scheme was applied to CT scans from 44 subjects, including 13 iNPH patients. The average difference in Evans index between the proposed method and manual measurement was 0.01 (1.6%), and the correlation coefficient of these data for the Evans index was 0.98. Therefore, this computerized method may have the potential to accurately compute Evans index for the diagnosis of iNPH on CT images.

  13. Neonatal Venous Thromboembolism.

    PubMed

    Haley, Kristina M

    2017-01-01

    Neonates are the pediatric population at highest risk for development of venous thromboembolism (VTE), and the incidence of VTE in the neonatal population is increasing. This is especially true in the critically ill population. Several large studies indicate that the incidence of neonatal VTE is up almost threefold in the last two decades. Central lines, fluid fluctuations, sepsis, liver dysfunction, and inflammation contribute to the risk profile for VTE development in ill neonates. In addition, the neonatal hemostatic system is different from that of older children and adults. Platelet function, pro- and anticoagulant proteins concentrations, and fibrinolytic pathway protein concentrations are developmentally regulated and generate a hemostatic homeostasis that is unique to the neonatal time period. The clinical picture of a critically ill neonate combined with the physiologically distinct neonatal hemostatic system easily fulfills the criteria for Virchow's triad with venous stasis, hypercoagulability, and endothelial injury and puts the neonatal patient at risk for VTE development. The presentation of a VTE in a neonate is similar to that of older children or adults and is dependent upon location of the VTE. Ultrasound is the most common diagnostic tool employed in identifying neonatal VTE, but relatively small vessels of the neonate as well as frequent low pulse pressure can make ultrasound less reliable. The diagnosis of a thrombophilic disorder in the neonatal population is unlikely to change management or outcome, and the role of thrombophilia testing in this population requires further study. Treatment of neonatal VTE is aimed at reducing VTE-associated morbidity and mortality. Recommendations for treating, though, cannot be extrapolated from guidelines for older children or adults. Neonates are at risk for bleeding complications, particularly younger neonates with more fragile intracranial vessels. Developmental alterations in the coagulation proteins as

  14. Neonatal and Perinatal Infections.

    PubMed

    Khan, Amira M; Morris, Shaun K; Bhutta, Zulfiqar A

    2017-08-01

    Lack of success in achieving considerable reductions in neonatal mortality is a contributory factor in failing to achieve Millennium Development Goal 4.2.6 million neonates still die each year, with preterm birth and infections the two leading causes. Maternal infections and environmental and infant factors influence acquisition of viral and bacterial infections in the perinatal and neonatal period. Scaling up evidence-based interventions addressing maternal risk factors and underlying causes could reduce neonatal infections by 84%. The emergence of new infections and increasing antimicrobial resistance present public health challenges that must be addressed to achieve substantial reductions in neonatal mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Transition state models for probing stereoinduction in Evans chiral auxiliary-based asymmetric aldol reactions.

    PubMed

    Shinisha, C B; Sunoj, Raghavan B

    2010-09-08

    The use of chiral auxiliaries is one of the most fundamental protocols employed in asymmetric synthesis. In the present study, stereoselectivity-determining factors in a chiral auxiliary-based asymmetric aldol reaction promoted by TiCl(4) are investigated by using density functional theory methods. The aldol reaction between chiral titanium enolate [derived from Evans propionyl oxazolidinone (1a) and its variants oxazolidinethione (1b) and thiazolidinethione (1c)] and benzaldehyde is examined by using transition-state modeling. Different stereochemical possibilities for the addition of titanium enolates to aldehyde are compared. On the basis of the coordination of the carbonyl/thiocarbonyl group of the chiral auxiliary with titanium, both pathways involving nonchelated and chelated transition states (TSs) are considered. The computed relative energies of the stereoselectivity-determining C-C bond formation TSs in the nonchelated pathway, for both 1a and 1c, indicate a preference toward Evans syn aldol product. The presence of a ring carbonyl or thiocarbonyl group in the chiral auxiliary renders the formation of neutral TiCl(3)-enolate, which otherwise is energetically less favored as compared to the anionic TiCl(4)-enolate. Hence, under suitable conditions, the reaction between titanium enolate and aldehyde is expected to be viable through chelated TSs leading to the selective formation of non-Evans syn aldol product. Experimentally known high stereoselectivity toward Evans syn aldol product is effectively rationalized by using the larger energy differences between the corresponding diastereomeric TSs. In both chelated and nonchelated pathways, the attack by the less hindered face of the enolate on aldehyde through a chair-like TS with an equatorial disposition of the aldehydic substituent is identified as the preferred mode. The steric hindrance offered by the isopropyl group and the possible chelation are identified as the key reasons behind the interesting

  16. Immune Responses in Neonates

    PubMed Central

    Basha, Saleem; Surendran, Naveen; Pichichero, Michael

    2015-01-01

    Neonates have little immunological memory and a developing immune system, which increases their vulnerability to infectious agents. Recent advances in understanding of neonatal immunity indicate that both innate and adaptive responses are dependent on precursor frequency of lymphocytes, antigenic dose and mode of exposure. Studies in neonatal mouse models and human umbilical cord blood cells demonstrate the capability of neonatal immune cells to produce immune responses similar to adults in some aspects but not others. This review focuses mainly on the developmental and functional mechanisms of the human neonatal immune system. In particular, the mechanism of innate and adaptive immunity and the role of neutrophils, antigen presenting cells, differences in subclasses of T lymphocytes (Th1, Th2, Tregs) and B cells are discussed. In addition, we have included the recent developments in neonatal mouse immune system. Understanding neonatal immunity is essential to development of therapeutic vaccines to combat newly emerging infectious agents. PMID:25088080

  17. Modeling ethanol decomposition on transition metals: a combined application of scaling and Brønsted-Evans-Polanyi relations.

    PubMed

    Ferrin, P; Simonetti, D; Kandoi, S; Kunkes, E; Dumesic, J A; Nørskov, J K; Mavrikakis, M

    2009-04-29

    Applying density functional theory (DFT) calculations to the rational design of catalysts for complex reaction networks has been an ongoing challenge, primarily because of the high computational cost of these calculations. Certain correlations can be used to reduce the number and complexity of DFT calculations necessary to describe trends in activity and selectivity across metal and alloy surfaces, thus extending the reach of DFT to more complex systems. In this work, the well-known family of Brønsted-Evans-Polanyi (BEP) correlations, connecting minima with maxima in the potential energy surface of elementary steps, in tandem with a scaling relation, connecting binding energies of complex adsorbates with those of simpler ones (e.g., C, O), is used to develop a potential-energy surface for ethanol decomposition on 10 transition metal surfaces. Using a simple kinetic model, the selectivity and activity on a subset of these surfaces are calculated. Experiments on supported catalysts verify that this simple model is reasonably accurate in describing reactivity trends across metals, suggesting that the combination of BEP and scaling relations may substantially reduce the cost of DFT calculations required for identifying reactivity descriptors of more complex reactions.

  18. Reverse Evans peroneus brevis medial ankle stabilization for balancing valgus ankle contracture during total ankle replacement.

    PubMed

    Roukis, Thomas S; Prissel, Mark A

    2014-01-01

    Medial ankle instability secondary to deltoid ligament insufficiency is frequently encountered when performing total ankle replacement and remains a challenge. In the present techniques report, we describe a "reverse" Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction for medial ankle stabilization harvested through limited incisions using simple topographic anatomic landmarks. The harvested peroneus brevis tendon is brought through a drill hole in the talus from laterally to medially, aiming for the junction of the talar neck and body plantar to the midline. The tendon is the brought superiorly and obliquely to the anterior medial aspect of the distal tibia where it is secured under a plate and screw construct. This modified Evans peroneus brevis tendon nonanatomic deltoid ligament reconstruction is useful in providing medial ankle stability during or after primary and revision total ankle replacement.

  19. Distribution of albumin in the normal monkey eye as revealed by Evans blue fluorescence microscopy.

    PubMed

    Radius, R L; Anderson, D R

    1980-03-01

    Since intravenously injected Evans blue binds irreversibly to serum albumin, its distribution reflects albumin exchange between the intravascular and extravascular tissue compartments. In histologic specimens examined by fluorescence, microscopy, extravasated Evans blue--albumin complex was identified within the ciliary body and trabecular meshwork of normal monkey eyes. In eyes fixed by intra-arterial perfusion of fixative, no dye was identified in the choroid, retina, or optic nerve. With immersion fixation, however, some extravasation was seen in the choroid and adjacent optic nerve. In some specimens, the optic nerve was stained not only with material apparently leaking from the choroid but also from a breakdown of the blood-brain barrier in the major disc vasculature during the interval before fixative penetrates into the tissue. Perfusion fixation must be used to avoid this artifact, and freezing techniques would be even better.

  20. Therapeutic management of evans syndrome in a pregnancy with maternal systemic lupus erythematosus.

    PubMed

    Nause, S L; Spiegler, J; Weichert, J; Hartge, D R

    2015-08-01

    A 31-year-old 2 G 1 P was referred to our unit of prenatal medicine at 35+3 weeks of gestation with a spontaneously conceived singleton pregnancy of a female fetus without detectable anomalies. Maternal hematological evaluation revealed an Evans-syndrome-related thrombocytopenia based on a lupus erythematosus. The former delivery was aggravated by a severe hemorrhage several years before. Anti-autoimmunologic therapy was started and maternal platelets count increased to physiological values. Uneventful ceasarean section was performed at 37 weeks of gestation with favourable outcome for mother and child. This case is the first report of a successful therapy in maternal Evans syndrome in pregnancy combined with a lupus erythematosus.

  1. Radioiodine sensitivity of parafollicular C cells in aged Long-Evans rats

    SciTech Connect

    Ott, R.A.; Hofmann, C.; Oslapas, R.; Nayyar, R.; Paloyan, E.

    1987-12-01

    An earlier study from our laboratory demonstrated that the incidence of thyroid C cell neoplasia in aging Long-Evans rats was high. When radioactive iodine was administered to 8-week-old Long-Evans rats, this incidence was reduced, although thyroid follicular cell neoplasia was increased. The aim of this study was to determine whether iodine-131 administered to an aged population of Long-Evans rats with established C cell hyperplasia would have a C cell ablative effect as pronounced as that observed in studies of young rats. For this study, 180 18-month-old Long-Evans rats (90 male and 90 female) were used. Baseline serum calcitonin levels were determined, and control and experimental groups containing equal numbers of animals were designated. /sup 131/I was administered by intraperitoneal injection to the experimental group, while equal volumes of saline solution were given to the control group. Blood samples for determination of serum calcitonin levels were obtained at 6-week intervals until the rats were 24 months old. Thyroid glands were then removed, and tissues were fixed, sectioned, and stained with hematoxylin and eosin and with peroxidase-antiperoxidase (PAP) using an anticalcitonin antibody. Examination of thyroid tissues showed that the incidence of C cell neoplasia was significantly reduced in irradiated animals as compared with nonirradiated controls (chi 2 analysis, p less than 0.05). PAP staining demonstrated diminished intracytoplasmic calcitonin in the radiation-treated group. Analysis of serum calcitonin levels over time showed significantly lower levels in the irradiated rat group than in the nonirradiated group (p less than 0.006).

  2. Spectrum analysis on Fisher-Kolmogorov-Petrovsky-Pischunov equation using Evans function approach

    NASA Astrophysics Data System (ADS)

    Lestari, I. I.; Bachtiar, A. A.; Wibowo, A.

    2017-07-01

    The eigenvalue of a dynamical system can be used to determine the stability of such system. In general, the eigenvalues will form two kinds of spectrum, i.e. the continuous and point spectra. This paper will presents two methods for determining the spectrum of eigenvalues, i.e., the Sturm-Liouville Theory and the Evans function. In this paper we use the Fisher-Kolmogorov-Petrovsky-Pischunov equation, as well as the Newton Raphson and Runge Kutta methods for numerical calculations.

  3. A survey of neonatal jaundice in association with household drugs and chemicals in Nigeria.

    PubMed

    Familusi, J B; Dawodu, A H

    1985-12-01

    A survey was conducted to determine the extent of exposure of women of child-bearing age and their families to household chemicals and medicaments, and the prevalence of neonatal jaundice in the exposed and unexposed families compared. Significant exposures to naphthalene, insecticides, mentholated balms, mentholated powders, and traditional herbs occurred in 45-87% of the families studied. The overall incidence of jaundice did not differ significantly in neonates from households with or without positive history of drugs/chemical exposures. Severe neonatal jaundice, as judged by the need for exchange blood transfusion or death of the infant, was however, significantly more frequent among neonates from families with positive history of naphthalene exposure than in those with negative history. Some household chemicals and medicaments may be important in the pathogenesis of neonatal jaundice in our environment, and health education aimed at eliminating exposure neonates and pregnant women to such agents is urgently necessary.

  4. Determination of intracranial tumor volumes in a rodent brain using magnetic resonance imaging, Evans blue, and histology: a comparative study.

    PubMed

    Prabhu, S S; Broaddus, W C; Oveissi, C; Berr, S S; Gillies, G T

    2000-02-01

    The measurement of tumor volumes is a practical and objective method of assessing the efficacy of a therapeutic agent. However, the relative accuracy of different methods of assessing tumor volume has been unclear. Using T1-weighted, gadolinium-enhanced magnetic resonance Imaging (T1-MRI), Evans Blue infusion and histology we measured intracranial tumor volumes in a rodent brain tumor model (RT2) at days 10, 16 and 18 after implantation of cells in the caudate putamen. There is a good correlation between tumor volumes comparing T1-MRI and Evans Blue (r2 = 0.99), T1-MRI and Histology (r2 = 0.98) and histology and Evans Blue (r2 = 0.93). Each of these methods is reliable in estimating tumor volumes in laboratory animals. There was significant uptake of gadolinium and Evans Blue in the tumor suggesting a wide disruption of the blood-brain barrier.

  5. Functional evaluation of the 10-year outcome after modified Evans repair for chronic ankle instability.

    PubMed

    Rosenbaum, D; Becker, H P; Sterk, J; Gerngross, H; Claes, L

    1997-12-01

    The Evans tenodesis is an operative treatment for chronic ankle instability with good short-term results. The disadvantage of impaired hind foot kinematics and restricted motion has been described, and only few reports of long-term results can be found. No techniques have been used to assess the outcome objectively. We wanted to determine whether a modified Evans procedure led to a satisfactory clinical and functional outcome. Nineteen patients were available at a 10-year follow-up. The clinical examination included a detailed questionnaire and stress radiographs. Foot function was evaluated with plantar pressure distribution measurements during walking and peroneal reaction time measurements elicited on a rapidly tilting platform (recorded with surface electromyography). High subjective patient satisfaction was contrasted with a high rate of residual instability, pain, and swelling. The radiographs showed an increased number of exostoses. The gait analysis revealed reduced peak pressures under the lateral heel and increased values under the longitudinal arch. The reaction times of the peroneal muscles were shorter on the operated side (significant: peroneus longus). The persistent clinical problems as well as the functional changes indicate that the disturbed ankle joint kinematics permanently alter foot function and may subsequently support the development of arthrosis. Therefore, the Evans procedure should only be applied if anatomical reconstruction of the lateral ankle ligaments is not feasible.

  6. Tissue-specific extravasation of albumin-bound Evans blue in hypothermic and rewarmed rats.

    PubMed

    Matthew, Candace B; Sils, Ingrid V; Bastille, Amy M

    2002-03-01

    The effects of hypothermia and rewarming on endothelial integrity were examined in intestines, kidney, heart, gastrocnemius muscle, liver, spleen, and brain by measuring albumin-bound Evans blue loss from the vasculature. Ten groups of twelve rats, normothermic with no pentobarbital, normothermic sampled at 2, 3, or 4 h after pentobarbital, hypothermic to 20, 25, or 30 degrees C, and rewarmed from 20, 25, or 30 degrees C, were cooled in copper coils through which water circulated. Hypothermic rats were cooled to the desired core temperature and maintained there for 1 h; rewarmed rats were cooled to the same core temperatures, maintained there for 1 h, and then rewarmed. Following Evans blue administration, animals were euthanized with methoxyflurane, tissues removed, and Evans blue extracted. Because hypothermia and rewarming significantly decrease blood flow, organ-specific flow rates for hypothermic and rewarmed tissues were used to predict extravasation. Hypothermia decreased extravasation in tissues with continuous endothelium (brain, muscle) and increased it in tissues with discontinuous endothelium (liver, lung, spleen). All tissues exhibited significant (p < 0.05) differences from normothermic controls. These differences are attributed to a combination of anesthesia, flow, and (or) change in endothelial permeability, suggesting that appropriate choice of organ and temperature would facilitate testing pharmacological means of promoting return to normal perfusion.

  7. NASA/NOAA's Suomi NPP Satellite's Night-time View of Cyclone Evan

    NASA Image and Video Library

    2017-09-27

    This night-time view of Cyclone Evan was taken from the Visible Infrared Imaging Radiometer Suite (VIIRS) on NASA/NOAA's Suomi National Polar-orbiting Partnership on Dec. 16, 2012. The rectangular bright object in the image is a lightning flash. "Because of the scan time as compared to how quickly lightning flashes, you get a nice streak in the data," said William Straka, of the University of Wisconsin-Madison, who provided this image. On Dec. 17 at 0900 UTC (4 a.m. EST), Cyclone Evan had maximum sustained winds near 115 knots (132 mph/213 kph). Evan was a Category 4 cyclone on the Saffir-Simpson Scale and was battering Fiji. Image Credit: NASA/NOAA/UWM/William Straka Text Credit: NASA Goddard/Rob Gutro NASA image use policy. NASA Goddard Space Flight Center enables NASA’s mission through four scientific endeavors: Earth Science, Heliophysics, Solar System Exploration, and Astrophysics. Goddard plays a leading role in NASA’s accomplishments by contributing compelling scientific knowledge to advance the Agency’s mission. Follow us on Twitter Like us on Facebook Find us on Instagram

  8. Foam separation of Rhodamine-G and Evans Blue using a simple separatory bottle system.

    PubMed

    Dasarathy, Dhweeja; Ito, Yoichiro

    2017-09-29

    A simple separatory glass bottle was used to improve separation effectiveness and cost efficiency while simultaneously creating a simpler system for separating biological compounds. Additionally, it was important to develop a scalable separation method so this would be applicable to both analytical and preparative separations. Compared to conventional foam separation methods, this method easily forms stable dry foam which ensures high purity of yielded fractions. A negatively charged surfactant, sodium dodecyl sulfate (SDS), was used as the ligand to carry a positively charged Rhodamine-G, leaving a negatively charged Evans Blue in the bottle. The performance of the separatory bottle was tested for separating Rhodamine-G from Evans Blue with sample sizes ranged from 1 to 12mg in preparative separations and 1-20μg in analytical separations under optimum conditions. These conditions including N2 gas pressure, spinning speed of contents with a magnetic stirrer, concentration of the ligand, volume of the solvent, and concentration of the sample, were all modified and optimized. Based on the calculations at their peak absorbances, Rhodamine-G and Evans Blue were efficiently separated in times ranging from 1h to 3h, depending on sample volume. Optimal conditions were found to be 60psi N2 pressure and 2mM SDS for the affinity ligand. This novel separation method will allow for rapid separation of biological compounds while simultaneously being scalable and cost effective. Published by Elsevier B.V.

  9. Direct current reduces accumulation of Evans Blue albumin in full-thickness burns.

    PubMed

    Chu, C S; Matylevich, N P; McManus, A T; Pruitt, B A; Goodwin, C W

    1999-08-01

    Application of direct current (DC) to a burn wound limits extension of the zone-of-stasis and reduces wound tissue edema. To study the effects of DC on extravasation of plasma proteins after burn by using Evans blue (EB) as a marker of plasma albumin. Male Sprague-Dawley rats with 20% total body surface area full-thickness scalds (100 degrees C/10 sec) were used as the experimental model. Burn wounds were treated with plain nylon, silver-nylon, silver-nylon and 40 microA DC, or no dressing. EB (30 mg/kg) was injected immediately or at variably delayed postburn (PB) times and accompanied by DC application at various time intervals PB. Tissue content of Evans blue was assessed at different times after injection of the dye or infliction of burn injury. Evans blue albumin (EBA) concentration in untreated burn wounds (307.7 microg/g tissue) was nine times greater than in unburned skin (36.5 microg/g tissue) at 48 hours PB. When animals received a DC and EB injection immediately PB, DC treatment reduced EBA concentration by 60% at any time point PB. When EB was injected immediately PB, or at variably delayed times PB, accompanied by DC immediately PB, or at variably delayed times PB, DC reduced EBA accumulation at all examined times PB by more the 50% (p < 0.001). EBA and edema fluid accumulation in burn wound change in concert after injury and show similar response to DC treatment.

  10. The moreau-evans hydrodynamic model applied to actual hall-héroult cells

    NASA Astrophysics Data System (ADS)

    Moreau, René J.; Ziegler, Donald

    1988-10-01

    An extension of the Moreau-Evans[1] model for Hall-Héroult cells hydrodynamics is presented. Numerical techniques are used to solve the Moreau-Evans model equations with realistic electromagnetic force fields; the predicted results are compared with those of another model which is the property of Kaiser Aluminum Company and whose results are considered as in fairly good agreement with available measurements (velocity in aluminum, for instance). The main input in this hydrodynamic model, i.e., the electromagnetic force field throughout the two liquids, was previously computed. For a given cell design these data were calculated using the electromagnetic program of Lympany and Evans.[2] For actual cells the forces were deduced from measurements of the magnetic field provided by Kaiser Aluminum Company. As expected, the cryolite flow is found to be governed by the large channels, and to be strongly dependent on the presence of such a channel between the two files of anodes. The use of numerical solution has made possible the analysis of new effects as the interfacial drag and the influence of small channels between anode blocks.

  11. A survey of natal and neonatal teeth in newborn infants.

    PubMed

    Wang, Chun-Hsiang; Lin, Yai-Tin; Lin, Yng-Tzer J

    2017-03-01

    Since there is no comprehensive research of natal and neonatal teeth in Taiwan, careful investigation of natal or neonatal teeth is worthy of being studied. This retrospective study investigated the prevalence and clinical characteristics of natal or neonatal teeth in a hospital setting, and analyzed the possible relationships between investigated variables of the natal or neonatal teeth. All of the 12,019 infants born at an assigned hospital between January 1, 2008 and December 31, 2014 were investigated for natal or neonatal teeth. The identified individuals were reviewed for systemic diseases. Dental examinations included the location, clinical appearance, and degree of mobility. A positive family history of natal or neonatal teeth and mother's physical condition before delivery were also investigated. The collected data were analyzed using Fisher's exact test. Thirty infants were identified with a total of 43 natal or neonatal teeth (females, 19; males, 11). Most of the teeth were in the mandibular primary incisor position (97.6%). A radiographic examination confirmed that not all of the natal or neonatal teeth were supernumerary. No significant differences were observed between males and females in tooth morphology, positive family history, and treatment methods (p > 0.05) or between normal and conical shapes in positive family history, premature infant, mother's physical condition before delivery, and treatment methods (p > 0.05). Most of the natal or neonatal teeth were in the mandibular primary incisor position and not all of them were supernumerary. No gender differences were found in tooth morphology, positive family history, and treatment methods. The tooth morphology was not significantly related to a positive family history, premature delivery, or the mother's physical condition before delivery. Copyright © 2016. Published by Elsevier B.V.

  12. Neonatal septic arthritis.

    PubMed

    Halder, D; Seng, Q B; Malik, A S; Choo, K E

    1996-09-01

    Neonatal septic arthritis has always been considered as separate from its counterpart in older children. The condition is uncommon but serious. Affected neonates usually survive, but with permanent skeletal deformities. Ten cases of neonatal septic arthritis were diagnosed between January 1989 and December 1993 in the neonatal intensive care units of two referral hospitals in the state of Kelantan, Malaysia. All except one neonate was born prematurely. The mean age of presentation was 15.6 days. Joint swelling (10/10), increased warmth (7/10) and erythema of the overlying skin (7/10) were the common presenting signs. Vague constitutional symptoms preceded the definitive signs of septic arthritis in all cases. The total white cell counts were raised with shift to the left. The knee (60%) was not commonly affected, followed by the hip (13%) and ankle (13%). Three neonates had multiple joint involvement. Coexistence of arthritis with osteomyelitis was observed in seven neonates. The commonest organism isolated was methicillin resistant Staphylococcus aureus (9/10). Needle aspiration was performed in nine neonates and one had incision with drainage. Follow up data was available for five neonates and two of these had skeletal morbidity. Early diagnosis by frequent examination of the joints, prompt treatment and control of nosocomial infection are important for management.

  13. Family Support and Education

    ERIC Educational Resources Information Center

    Goldstein, Lou Ann

    2013-01-01

    Family involvement is essential to the developmental outcome of infants born into Neonatal Intensive Care Unit (NICU). In this article, evidence has been presented on the parent's perspective of having an infant in the NICU and the context of family. Key points to an educational assessment are also reviewed. Throughout, the parent's concerns and…

  14. Family Support and Education

    ERIC Educational Resources Information Center

    Goldstein, Lou Ann

    2013-01-01

    Family involvement is essential to the developmental outcome of infants born into Neonatal Intensive Care Unit (NICU). In this article, evidence has been presented on the parent's perspective of having an infant in the NICU and the context of family. Key points to an educational assessment are also reviewed. Throughout, the parent's concerns and…

  15. Development of later life spontaneous seizures in a rodent model of hypoxia induced neonatal seizures

    PubMed Central

    Rakhade, Sanjay N; Klein, Peter; Huynh, Thanthao; Hilario-Gomez, Cristina; Kosaras, Bela; Rotenberg, Alexander; Jensen, Frances E.

    2011-01-01

    Summary Purpose To study the development of epilepsy following hypoxia-induced neonatal seizures in Long Evans rats and to establish the presence of spontaneous seizures in this model of early life seizures. Methods Long-Evans rat pups were subjected to hypoxia-induced neonatal seizures at postnatal day 10 (P10). Epidural cortical electroencephalography (EEG) and hippocampal depth electrodes were used to detect the presence of seizures in later adulthood (>P60). In addition, subdermal wire electrode recordings were used to monitor age at onset and progression of seizures in the juvenile period, at intervals between P10–P60. Timm staining was performed to evaluate mossy fiber sprouting in the hippocampi of P100 adult rats that had experienced neonatal seizures. Key Findings In recordings made from adult rats (P60–P180), the prevalence of epilepsy in cortical and hippocampal EEG recordings was 94.4% following early life hypoxic seizures. These spontaneous seizures were identified by characteristic spike and wave activity on EEG accompanied by behavioral arrest and facial automatisms (electroclinical seizures). Phenobarbital injection transiently abolished spontaneous seizures. EEG in the juvenile period (P10–60) showed that spontaneous seizures first occurred approximately 2 weeks after the initial episode of hypoxic seizures. Following this period, spontaneous seizure frequency and duration progressively increased with time. Furthermore, significantly increased sprouting of mossy fibers was observed in the CA3 pyramidal cell layer of the hippocampus in adult animals following hypoxia-induced neonatal seizures. Notably, Fluoro-Jade B staining confirmed that hypoxic seizures at P10 did not induce acute neuronal death. Significance The rodent model of hypoxia-induced neonatal seizures leads to the development of epilepsy in later life, accompanied by increased mossy fiber sprouting. In addition, this model appears to exhibit a seizure-free latent period

  16. Management of Neonatal Candidiasis

    PubMed Central

    Cohen-Wolkowiez, Michael; Benjamin, Daniel K; Smith, P Brian

    2009-01-01

    Invasive candidiasis (IC) is common and often fatal in extremely premature neonates. In the last decade, the therapeutic armamentarium for IC has markedly expanded; however, the pharmacokinetics, safety and efficacy of most antifungal agents in premature neonates are unknown. We will review the major systemic antifungal agents in clinical use. PMID:9849983

  17. Futile care and the neonate.

    PubMed

    Romesberg, Tricia L

    2003-10-01

    The concept of futile care is controversial and difficult to define. Efforts to prolong life, once considered an outcome of healing, may now be viewed by some as harmful acts of prolonging suffering. This article reviews a number of cases representing this challenging ethical dilemma, such as Baby K and MacDonald v. Milleville. The Baby Doe regulations, the Emergency Medical Treatment and Labor Act (EMTALA), and the Born-Alive Protection Act of 2001, also are discussed to provide an improved understanding of the legal framework that impacts ethical decision making. Nurses at the bedside must be equipped with the ethical knowledge and communication skills necessary to care for patients and families facing the ethical dilemma of futile care. An increased focus on neonatal palliative care is suggested to provide infants, families, and staff with the necessary tools to work through this painful process.

  18. Redirecting treatment during neonatal transport.

    PubMed

    Dulkerian, Susan J; Douglas, Webra Price; Taylor, Renee McCraine

    2011-01-01

    Neonatal transport teams comprise multidisciplinary health care providers who are skilled in patient care, communication and customer service, and equipment mechanics. They are extensively trained in resuscitation and stabilization, preparing for accelerating care, and their focus is preservation of life. In any situation focused on caring for critically ill patients, ethical issues and questions may arise. For instance, is it compassionate and/or cost-effective to separate mothers and infants when continuing/accelerating care is futile, and when and how should care be redirected from acute and lifesaving care to comfort care and bereavement support for the family? The knowledge and skills required to address such situations and communicate and participate in a redirection of care may not be adequately emphasized in the preparation of the professionals responsible for stabilizing and transporting critically ill newborns. This article raises issues relating to transport and redirecting care such as eligibility for transport, parental request and consent, separation of mothers and infants, palliative and bereavement care, ethical considerations, competitive transport environment, and customer service. A shared mental model is essential. The focus of this article is not to provide answers to all of these issues, but to highlight the complexity of the topic of redirecting treatment during neonatal transport. Redirecting treatment needs to be discussed, and health care professionals should be prepared during their transport team training. Each family and situation must be approached individually, with the acceptance that there will always be more questions than answers.

  19. Evans blue staining of cardiomyocytes induced by myocardial contrast echocardiography in rats: evidence for necrosis instead of apoptosis.

    PubMed

    Miller, Douglas L; Li, Peng; Dou, Chunyan; Armstrong, William F; Gordon, David

    2007-12-01

    High mechanical index (MI) echocardiography with contrast agent has been shown to induce Evans blue staining of cardiomyocytes, seen 1 d after exposure, in addition to contraction band necrosis, seen immediately after exposure. This research examined the roles of necrosis vs. apoptosis in these bioeffects. Myocardial contrast echocardiography at high MI with 1:4 electrocardiogram triggering was performed in anesthetized rats at 1.5 MHz. Histologically observable cell injury was accumulated by infusing a high dose of 50 microL/kg ultrasound contrast media via tail vein for 5 min at the start of 10 min of scanning. Evans blue dye or propidium iodide was injected as an indicator of cardiomyocyte plasma membrane integrity. Histologic sections were stained using the terminal dUTP nick-end labeling (TUNEL) method for labeling nuclei with DNA degradation (e.g., apoptosis). Evans blue fluorescent cells were counted on frozen sections or on hematoxylin-stained and TUNEL-labeled paraffin sections. In addition, transmission electron microscopy was used to assess potential apoptotic nuclei. Hypercontraction and propidium iodide staining were observed immediately after imaging exposure. Although TUNEL-positive cells were evident after 4 h, these also had indications of contraction band necrosis, and features of apoptosis were not confirmed by electron microscopy. Inflammatory cell infiltration was evident after 24 h. A second, more subtle injury was recognized by Evans blue staining, with minimal inflammatory cell infiltration at the morphologically intact stained cells after 24 h. Apoptosis was not detected by the TUNEL method in the cardiomyocytes stained with Evans blue at 24 h. However, Evans blue-stained cell numbers declined after 48 h, with continued inflammatory cell infiltration. The initial insult for Evans blue-stained cardiomyocytes apparently induced partial permeability of the plasma membrane, which led to gradual degeneration (but not apoptosis) and necrosis

  20. Principles of genetics and their clinical application in the neonatal intensive care unit.

    PubMed

    Schiefelbein, Julieanne H; Cheeseman, Susan E

    2009-03-01

    The neonate born with a genetic defect or fetal anomaly presents a challenge to the neonatal intensive care unit team. Typically genetic disorders are thought of as being rare; however, this is not true, and it is becoming increasingly evident as knowledge and technology progress. A definitive diagnosis is essential for management and care of the neonate and the neonate's family. An evidence-based approach to the neonate who has a suspected genetic anomaly is essential to provide accurate diagnosis and to guide ongoing care. This article gives an overview of basic genetics and genetic counseling, and applies the principles to two case studies.

  1. Pain management in neonates.

    PubMed

    Carbajal, Ricardo; Gall, Olivier; Annequin, Daniel

    2004-05-01

    Multiple lines of evidence suggest an increased sensitivity to pain in neonates. Repeated and prolonged pain exposure may affect the subsequent development of pain systems, as well as potentially contribute to alterations in long-term development and behavior. Despite impressive gains in the knowledge of neonatal pain mechanisms and strategies to treat neonatal pain acquired during the last 15 years, a large gap still exists between routine clinical practice and research results. Accurate assessment of pain is crucial for effective pain management in neonates. Neonatal pain management should rely on current scientific evidence more than the attitudes and beliefs of care-givers. Parents should be informed of pain relief strategies and their participation in the health care plan to alleviate pain should be encouraged. The need for systemic analgesia for both moderate and severe pain, in conjunction with behavioral/environmental approaches to pain management, is emphasized. A main sources of pain in the neonate is procedural pain which should always be prevented and treated. Nonpharmacological approaches constitute important treatment options for managing procedural pain. Nonpharmacological interventions (environmental and preventive measures, non-nutritive sucking, sweet solutions, skin-skin contact, and breastfeeding analgesia) can reduce neonatal pain indirectly by reducing the total amount of noxious stimuli to which infants are exposed, and directly, by blocking nociceptive transduction or transmission or by activation of descending inhibitory pathways or by activating attention and arousal systems that modulate pain. Opioids are the mainstay of pharmacological pain treatment but there are other useful medications and techniques that may be used for pain relief. National guidelines are necessary to improve neonatal pain management at the institutional level, individual neonatal intensive care units need to develop specific practice guidelines regarding pain

  2. Neonatal euthanasia: moral considerations and criminal liability

    PubMed Central

    Sklansky, M.

    2001-01-01

    Despite tremendous advances in medical care for critically ill newborn infants, caregivers in neonatal intensive care units still struggle with how to approach those patients whose prognoses appear to be the most grim, and whose treatments appear to be the most futile. Although the practice of passive neonatal euthanasia, from a moral perspective, has been widely (albeit quietly) condoned, those clinicians and families involved in such cases may still be found legally guilty of child abuse or even manslaughter. Passive neonatal euthanasia remains both a moral dilemma and a legal ambiguity. Even the definition of passive euthanasia remains unclear. This manuscript reviews the basic moral and legal considerations raised by the current practice of neonatal euthanasia, and examines the formal position statements of the American Medical Association and the American Academy of Pediatrics. The paper concludes by emphasising the need, at least in the United States, to clarify the legal status of this relatively common medical practice. Key Words: Euthanasia • neonatal intensive care • defective newborns PMID:11233379

  3. Plasma volume methodology: Evans blue, hemoglobin-hematocrit, and mass density transformations

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Hinghofer-Szalkay, H.

    1985-01-01

    Methods for measuring absolute levels and changes in plasma volume are presented along with derivations of pertinent equations. Reduction in variability of the Evans blue dye dilution technique using chromatographic column purification suggests that the day-to-day variability in the plasma volume in humans is less than + or - 20 m1. Mass density determination using the mechanical-oscillator technique provides a method for measuring vascular fluid shifts continuously for assessing the density of the filtrate, and for quantifying movements of protein across microvascular walls. Equations for the calculation of volume and density of shifted fluid are presented.

  4. Isolated non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage in a patient with Evans syndrome.

    PubMed

    Abdul Rashid, Anna Misyail; Md Noh, Mohamad Syafeeq Faeez

    2017-08-25

    Non-traumatic, spontaneous subarachnoid hemorrhage occurs in approximately 85% of cases where there is a ruptured saccular aneurysm. An additional 10% of cases arise from non-aneurysmal peri-mesencephalic hemorrhages. We report a rare case of a young female, with underlying Evans syndrome, who was initially thought to have non-hemorrhagic stroke, eventually diagnosed having isolated non-traumatic, non-aneurysmal convexal subarachnoid haemorrhage. Spontaneous non-traumatic, non-aneurysmal convexal subarachnoid hemorrhage is a rare entity - of which there are multiple possible etiologies.

  5. Taxonomic revision of Cumbre Evans, 1955 (Hesperiidae: Hesperiinae: Moncini), with the description of two new species.

    PubMed

    Dolibaina, Diego Rodrigo; Mielke, Olaf Hermann Hendrik; Casagrande, Mirna Martins

    2014-07-24

    The genus Cumbre Evans, 1955 (Hesperiidae: Heperiinae: Moncini) and its respective species are revised. Two new species are described, Cumbre haywardi sp. nov. from Peru and Argentina (type locality) and Cumbre lamasi sp. nov. from Ecuador and Peru (type locality). A lectotype for Phanis cumbre Schaus, 1902 is designated. The examination of the Phanes triumviralis Hayward, 1939 and Phanes belli Hayward, 1939 holotypes indicates that these taxa are new synonyms (n. syn.) of Poanes meridionalis Hayward, 1934, which is a valid species (stat. rev.). 

  6. A redetermination of the Barnes-Evans relation for surface flux in the V band

    NASA Astrophysics Data System (ADS)

    Eaton, J. A.; Poe, C. H.

    Published BVRI photometry for stars with angular diameters established by lunar occultation or speckle and amplitude interferometry or from their variability are compiled in tables and used to reevaluate the visual-flux/color relation proposed by Barnes and Evans (1976). The results are presented in graphs and tables for red and blue stars, and the relation derived is used to correct the UVBRI temperature calibration of Johnson (1966). Reasonable agreement is found with the temperature and bolometric-correction scales of Code (1976) for the red stars, but not for the blue stars.

  7. Pediatric epilepsy following neonatal seizures symptomatic of stroke.

    PubMed

    Suppiej, Agnese; Mastrangelo, Massimo; Mastella, Laura; Accorsi, Patrizia; Grazian, Luisa; Casara, Gianluca; Peruzzi, Cinzia; Carpanelli, Maria Luisa; Janes, Augusta; Traverso, Annalisa; Dalla Bernardina, Bernardo

    2016-01-01

    Neonatal seizures are a risk factor for later epilepsy and their etiology is known to be implicated in the outcome but, little is known about this issue in the subgroup of seizures symptomatic of perinatal arterial ischemic stroke. The aim of this study was to describe the long term risk of epilepsy after electroencephalographic confirmed neonatal seizures symptomatic of perinatal arterial ischemic stroke. Fifty-five patients with electroclinical ictal data, vascular territory confirmed by neuroimaging and a minimum follow up of 3.5 years were identified from a multi-centre prospective neonatal seizures registry. Primary outcome was occurrence of post-neonatal epilepsy. The association of outcome with family history of epilepsy, gender, location of the infarct, neonatal clinical and electroencephalogram data were also studied. During a mean follow up of 8 years and 5 months, 16.4% of the patients developed post neonatal epilepsy. The mean age at first post neonatal seizure was 4 years and 2 months (range 1-10 years and 6 months). Location of the infarct was the only statistically significant risk factor (p=0.001); epilepsy was more represented in males but the difference was not statistically significant. Neonatal seizures symptomatic of perinatal arterial ischemic stroke had lower risk and later onset of post-neonatal epilepsy, compared to seizures described in the setting of other perinatal brain insults. Our data have implications for counseling to the family at discharge from neonatal intensive care unit. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  8. Neonatal Brain Tumors: A Review

    PubMed Central

    Bodeliwala, Shaam; Kumar, Vikas; Singh, Daljit

    2017-01-01

    Brain tumors in neonatal age group is uncommon comparing with older children and adults. In older children brain tumors are commonly infratentorial, where as in neonates, they are supratentorial. Though extracranial tumors are commoner in neonates, brain tumors cause 5-20% deaths approximately. We are presenting a review on brain tumors in neonates. PMID:28770127

  9. Neonatal abstinence syndrome.

    PubMed

    Serane, V Tiroumourougane; Kurian, Ommen

    2008-09-01

    To study the substance misuse in pregnant mothers and its impact on their newborns. Case note review of the study population was undertaken. Infants of mothers who had taken substance of misuse were monitored regularly using Finnegan's score and treatment initiated based on a pre-existing protocol. The parameters that were studied included maternal drug habits, antenatal problems, and neonatal epidemiology with particular reference to growth, neonatal abstinence syndrome (NAS), its severity and management. Out of 32 neonates, 28 had developed neonatal withdrawal requiring treatment. The earliest presentation of NAS was at six hours and the average time of presentation of NAS was 26 hours. The dose of methadone taken by the mother related well with the likelihood of development of NAS. The most common symptoms noted at the time of diagnosis were irritable cry, increased tone, tachypnea, sleeplessness and tremor. Majority of neonates born to mothers on methadone exhibit neonatal abstinence syndrome and require pharmacological treatment. Neonates who had not exhibited symptoms of drug withdrawal within the first 3 days of life are unlikely to present with NAS requiring treatment.

  10. Neonatal outreach simulation.

    PubMed

    Byrne, Bobbi J; Manhas, Deepak

    2016-11-01

    Numerous factors contribute to neonatal morbidity and mortality, and inexperienced providers managing crisis situations is one major cause. Simulation-based medical education is an excellent modality to employ in community hospitals to help refine and refresh resuscitation skills of providers who infrequently encounter neonatal emergencies. Mounting evidence suggests that simulation-based education improves patient outcomes. Academic health centers have the potential to improve neonatal outcomes through collaborations with community hospital providers, sharing expertise in neonatal resuscitation and simulation. Community outreach programs using simulation have been successfully initiated in North America. Two examples of programs are described here, including the models for curricular development, required resources, limitations, and benefits. Considerations for initiating outreach simulation programs are discussed. In the future, research demonstrating improved neonatal outcomes using outreach simulation will be important for personnel conducting outreach programs. Neonatal outreach simulation is a promising educational endeavor that may ultimately prove important in decreasing neonatal morbidity and mortality. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Review of neonatal EEG.

    PubMed

    Husain, Aatif M

    2005-03-01

    Neonatal electroencephalography (EEG) presents some of the most difficult challenges in EEG interpretation. It differs significantly in many ways from EEG of older children and adults. Technologically, acquisition of a neonatal EEG is significantly more difficult and different than an adult EEG. There are numerous features that are age-specific and change almost week-to-week in the preterm infant. Some features may be normal at one age and abnormal if they persist for several weeks. Many of these features also have different implications in neonates as compared to older individuals. These issues mandate a different approach to neonatal EEG interpretation. In this article an overview of neonatal EEG is presented. After a brief discussion of relevant technical issues, various normal EEG features encountered in neonates are discussed. This is followed by a discussion of the ontogeny of EEG, starting from the age of viability to the first few months of life. A description of various abnormalities follows. Finally, an approach to analysis of a neonatal EEG is presented.

  12. Birth Tourism and Neonatal Intensive Care: A Children's Hospital Experience.

    PubMed

    Mikhael, Michel; Cleary, John P; Dhar, Vijay; Chen, Yanjun; Nguyen, Danh V; Chang, Anthony C

    2016-12-01

    Objective The aim of this article is to examine characteristics of birth tourism (BT) neonates admitted to a neonatal intensive care unit (NICU). Methods This was a retrospective review over 3 years; BT cases were identified, and relevant perinatal, medical, social, and financial data were collected and compared with 100 randomly selected non-birth tourism neonates. Results A total of 46 BT neonates were identified. They were more likely to be born to older women (34 vs. 29 years; p < 0.001), via cesarean delivery (72 vs. 48%; p = 0.007), and at a referral facility (80 vs. 32%; p < 0.001). BT group had longer hospital stay (15 vs. 7 days; p = 0.02), more surgical intervention (50 vs. 21%; p < 0.001), and higher hospital charges (median $287,501 vs. $103,105; p = 0.003). One-third of BT neonates were enrolled in public health insurance program and four BT neonates (10%) were placed for adoption. Conclusion Families of BT neonates admitted to the NICU face significant challenges. Larger studies are needed to better define impacts on families, health care system, and society.

  13. Oral Lesions in Neonates

    PubMed Central

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  14. Effect of dehydroepiandrosterone on insulin sensitivity in Otsuka Long-Evans Tokushima-fatty rats.

    PubMed

    Ishizuka, Tatsuo; Miura, Atsushi; Kajita, Kazuo; Matsumoto, Masami; Sugiyama, Chiyo; Matsubara, Kenji; Ikeda, Takahide; Mori, Ichiro; Morita, Hiroyuki; Uno, Yoshihiro; Mune, Tomoatsu; Kanoh, Yoshinori; Ishizawa, Masayoshi

    2007-12-01

    In order to clarify the effect of dehydroepiandrosterone (DHEA) on improvement of insulin resistance, we examined the effects of overexpression of wild-type protein kinase C-zeta (wt-PKCzeta)/3-phosphoinositide-dependent protein kinase-1 (wt-PDK1) and kinase-inactive PKCzeta/PDK1 (DeltaPKCzeta/DeltaPDK1) on DHEA-induced [(3)H]2-deoxyglucose (DOG) uptake using the electroporation method in rat adipocytes. Overexpression of wt-PKCzeta and wt-PDK1 significantly increased in DHEA-induced [(3)H]2-DOG uptake. Wortmannin completely suppressed DHEA-induced [(3)H]2-DOG uptake in wt-PKCzeta- and wt-PDK1-transfected adipocytes. Overexpression of neither DeltaPKCzeta nor DeltaPDK1 increased DHEA-induced [(3)H]2-DOG uptake. Otsuka Long-Evans fatty rats (OLETF), animal models of type 2 diabetes, and Long-Evans Tokushima rats (LETO) as control, were treated with 0.4% DHEA for 2 weeks. Insulin-induced [(3)H]2-DOG uptakes, activations of PI 3-kinase and PKCzeta of adipocytes were significantly increased in DHEA-treated OLETF rats. Moreover, plasma glucose levels in OLETF rats after treatment with DHEA for 2 weeks were significantly lower than treatment without DHEA, but not in LETO rats. These results indicate that DHEA treatment may improve glucose tolerance through a PI 3-kinase-PKCzeta pathway and downregulates adiposity in OLETF rats.

  15. Toxicity and bioaccumulation of the wood preservative copper dimethyldithiocarbamate in tissues of Long-Evans rats.

    PubMed

    Scharf, Brian; Trombetta, Louis David

    2008-01-01

    This study examined the toxicity and accumulation of copper in the livers and kidneys of Long-Evans rats after a subacute exposure to copper dimethyldithiocarbamate (CDCC) wood preservative. CDDC was recently introduced as an alternative to chromated copper arsenate (CCA) preserved wood. Female rats (220-270 g) were treated with 0, 25, 50, or 75 mg/kg CDDC by oral gavage for 3 wk. Light microscopy revealed that higher doses of CDDC induced diffuse necrosis and a loss of sinusoids in the livers of Long-Evans rats with vacuolization in the highest dose. Rats treated with 25 mg/kg CDDC displayed a thickening of the basement membrane of Bowman's capsule and the mesangium. Exposure to higher CDDC concentrations (50 and 75 mg/kg) showed moderate to marked expansion of the mesangial matrix and glomerular necrosis with an overall loss of glomerular structure seen in the highest dose. The concentration of copper was significantly increased in the tissues of animals exposed to CDDC in a dose-dependent manner. Western blot analysis revealed the induction of the stress protein Hsp70 and the formation of 4-hydroxy-2-nonenal (4HNE) adducts in liver and renal tissues, indicating peroxidative damage. CDDC was shown to be toxic to the livers and kidneys, at all doses used, and this toxicity is related to peroxidative insult.

  16. Absence of diurnal variation in visceromotor response to colorectal distention in normal Long Evans rats

    PubMed Central

    Welting, Olaf; Cailotto, Cathy; Kalsbeek, Andries; van den Wijngaard, Rene

    2016-01-01

    Background: Enhanced colorectal sensitivity (i.e. visceral hypersensitivity) is thought to be a pathophysiological mechanism in irritable bowel syndrome (IBS). In healthy men a circadian variation in rectal perception to colonic distention was described. Disturbed day and night rhythms, which occur in shift work and trans meridian flights, are associated with the prevalence of IBS. This raises the question whether disruptions of circadian control are responsible for the observed pathology in IBS. Prior to investigating altered rhythmicity in relation to visceral hypersensitivity in a rat model for IBS, it is relevant to establish whether normal rats display circadian variation similar to healthy men.  Methodology and findings: In rodents colorectal distension leads to reproducible contractions of abdominal musculature. We used quantification of this so called visceromotor response (VMR) by electromyography (EMG) to assess visceral sensitivity in rats. We assessed the VMR in normal male Long Evans rats at different time points of the light/dark cycle. Although a control experiment with male maternal separated rats confirmed that intentionally inflicted (i.e. stress induced) changes in VMR can be detected, normal male Long Evans rats showed no variation in VMR along the light/dark cycle in response to colorectal distension. Conclusions: In the absence of a daily rhythm of colorectal sensitivity in normal control rats it is not possible to investigate possible aberrancies in our rat model for IBS. PMID:26925229

  17. Genetics Home Reference: benign familial neonatal seizures

    MedlinePlus

    ... 15 percent of people with BFNS , recurrent seizures (epilepsy) will come back later in life after the ... with BFNS have gone away. The age that epilepsy begins is variable. Related Information What does it ...

  18. The Mount Evans batholith in the Colorado Front Range: revision of its age and reinterpretation of its structure

    USGS Publications Warehouse

    Aleinikoff, J.N.; Reed, J.C.; Dewitt, E.

    1993-01-01

    The Mount Evans batholith is composed of a main phase of massive to conspicuously foliated monzogranite and granodiorite and undeformed aplite and pegmatite. The Mount Evans batholith was previously considered to be part of the 1.7 Ga Routt Plutonic Suite. New U-Pb zircon ages on four samples (granodiorite, monzogranite, and granite), however, indicate that the batholith was emplaced at 1442 ?? 2 Ma and belongs to the Berthoud Plutonic Suite. Most of the batholith has igneous textures and structures, except in the vicinity of the Idaho Springs-Ralston shear zone where those features are tectonically recrystallized and foliated. The Mount Evans batholith is anomalous in composition and structure compared to most other 1.4 Ga plutons of the southwestern US. The differences probably reflect different sources of partial melting; the specific tectonic setting where rocks of such disparate origin are temporally and spatially juxtaposed is not understood. -from Authors

  19. Joint reproductive autonomy: does Evans v Amicus Healthcare Ltd provide for a gender-neutral approach to assisted reproductive rights?

    PubMed

    Allin, Michael J

    2015-06-01

    Assisted reproductive technology encompasses methods of achieving pregnancy by artificial or partially artificial means. Whilst these methods are more commonly used by couples suffering from problems of infertility, some forms of assistance are employed by fertile couples, for example pre-implantation genetic diagnosis. The overall regulatory framework in the UK is predominantly found in the Human Fertilisation and Embryology Act 1990. The usual rules relating to consent and autonomy apply and were discussed in depth in Evans v Amicus Healthcare Ltd and later in Evans v United Kingdom. This paper considers whether the Evans litigation envisages the possibility of further encouraging joint autonomy in the use of zygotes and whether there is a continuing right to autonomy by the party not bearing the pregnancy.

  20. Consanguinity and Neonatal Death: A Nested Case-Control Study

    PubMed Central

    Chaman, Reza; Gholami Taramsari, Mahshid; Khosravi, Ahmad; Amiri, Mohammad; Holakouie Naieni, Kourosh; Yunesian, Masoud

    2014-01-01

    Objective: Although numerous studies have found higher rates of abortion and still births following consanguinity (familial marriages), the question of whether consanguinity significantly increases the risk of neonatal death has inadequately been addressed.This study aims to evaluate familial marriage effects on neonatal death in rural areas in Iran. Materials and methods: In this nested case-control study, 6900 newbornswho were born in rural areas of Kohgiluyeh and Boyerahmad Province (South-West of Iran)were followed till the end of neonatal period, and neonatal death was the outcome of interest. Subsequently 97 cases and 97 controls were selected in study cohort by using risk set sampling model. Crude and adjusted odds ratios (OR) were estimated by usinga conditional logistic regression model. Results: In the final model, prematurity (OR = 5.57), low birthweight (LBW) (OR = 7.68), consanguinity (first cousins) (OR = 5.23), C-section (OR = 7.27), birth rank more than 3 (OR = 6.95) and birthsinterval less than 24 months (OR = 4.65) showed significant statistical association with neonatal mortality (p < 0.05). Conclusion: According to our findings, after adjusting the effects of other significant risk factors, familial marriageto first cousins is considered asan important risk factor for neonatal death. PMID:25530772

  1. Teaching antenatal counseling skills to neonatal providers.

    PubMed

    Stokes, Theophil A; Watson, Katie L; Boss, Renee D

    2014-02-01

    Counseling a family confronted with the birth of a periviable neonate is one of the most difficult tasks that a neonatologist must perform. The neonatologist's goal is to facilitate an informed, collaborative decision about whether life-sustaining therapies are in the best interest of this baby. Neonatologists are trained to provide families with a detailed account of the morbidity and mortality data they believe are necessary to facilitate a truly informed decision. Yet these complicated and intensely emotional conversations require advanced communication and counseling skills that our current fellowship-training strategies are not adequately providing. We review educational models for training neonatology fellows to provide antenatal counseling at the threshold of viability. We believe that training aimed at teaching these skills should be incorporated into the neonatal-perinatal medicine fellowship. The optimal approaches for teaching these skills remain uncertain, and there is a need for continued innovation and outcomes-based research. Published by Elsevier Inc.

  2. Neonatal hepatitis syndrome.

    PubMed

    Roberts, Eve A

    2003-10-01

    Conjugated hyperbilirubinaemia in an infant indicates neonatal liver disease. This neonatal hepatitis syndrome has numerous possible causes, classified as infective, anatomic/structural, metabolic, genetic, neoplastic, vascular, toxic, immune and idiopathic. Any infant who is jaundiced at 2-4 weeks old needs to have the serum conjugated bilirubin measured, even if he/she looks otherwise well. If conjugated hyperbilirubinaemia is present, a methodical and comprehensive diagnostic investigation should be performed. Early diagnosis is critical for the best outcome. In particular, palliative surgery for extrahepatic biliary atresia has the best chance of success if performed before the infant is 8 weeks old. Definitive treatments available for many causes of neonatal hepatitis syndrome should be started as soon as possible. Alternatively, liver transplantation may be life saving. Supportive care, especially with attention to nutritional needs, is important for all infants with neonatal hepatitis syndrome.

  3. Maternal and neonatal tetanus

    PubMed Central

    Thwaites, C Louise; Beeching, Nicholas J; Newton, Charles R

    2017-01-01

    Maternal and neonatal tetanus is still a substantial but preventable cause of mortality in many developing countries. Case fatality from these diseases remains high and treatment is limited by scarcity of resources and effective drug treatments. The Maternal and Neonatal Tetanus Elimination Initiative, launched by WHO and its partners, has made substantial progress in eliminating maternal and neonatal tetanus. Sustained emphasis on improvement of vaccination coverage, birth hygiene, and surveillance, with specific approaches in high-risk areas, has meant that the incidence of the disease continues to fall. Despite this progress, an estimated 58 000 neonates and an unknown number of mothers die every year from tetanus. As of June, 2014, 24 countries are still to eliminate the disease. Maintenance of elimination needs ongoing vaccination programmes and improved public health infrastructure. PMID:25149223

  4. Monitoring neonates for ototoxicity.

    PubMed

    Garinis, Angela C; Kemph, Alison; Tharpe, Anne Marie; Weitkamp, Joern-Hendrik; McEvoy, Cynthia; Steyger, Peter S

    2017-06-22

    Neonates admitted to the neonatal intensive care unit (NICU) are at greater risk of permanent hearing loss compared to infants in well mother and baby units. Several factors have been associated with this increased prevalence of hearing loss, including congenital infections (e.g. cytomegalovirus or syphilis), ototoxic drugs (such as aminoglycoside or glycopeptide antibiotics), low birth weight, hypoxia and length of stay. The aetiology of this increased prevalence of hearing loss remains poorly understood. Here we review current practice and discuss the feasibility of designing improved ototoxicity screening and monitoring protocols to better identify acquired, drug-induced hearing loss in NICU neonates. A review of published literature. We conclude that current audiological screening or monitoring protocols for neonates are not designed to adequately detect early onset of ototoxicity. This paper offers a detailed review of evidence-based research, and offers recommendations for developing and implementing an ototoxicity monitoring protocol for young infants, before and after discharge from the hospital.

  5. Neonatal mortality in Utah.

    PubMed

    Woolley, F R; Schuman, K L; Lyon, J L

    1982-09-01

    A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e., tobacco and alcohol abstinence, differential neonatal mortality rates were calculated. The influence of potential confounding factors was evaluated. Low activity LDS members were found to have an excess risk of neonatal death five times greater than high activity LDS, with an upper bound of a two-sided 95% confidence interval of 7.9. The data consistently indicate a lower neonatal mortality rate for active LDS members. Non-LDS were found to have a lower rate than either medium or low activity LDS.

  6. Neonatal abstinence syndrome

    MedlinePlus

    NAS; Neonatal abstinence symptoms ... may contribute to the severity of a baby's NAS symptoms. ... symptoms of withdrawal. Even after medical treatment for NAS is over and babies leave the hospital, they ...

  7. [Neonatal lupus erythematosus].

    PubMed

    Mayet, W J; Hermann, E; Bachmann, M; Poralla, T; Meyer zum Büschenfelde, K H

    1989-01-01

    The neonatal lupus erythematosus syndrome, first described by McCuistion and Schoch in 1954, is associated with characteristic skin lesions and congenital heart block in the new-born, and the presence of Ro-(SSA), La-(SSB), or RNP antibodies in mothers and infants. A transplacental transference of maternal autoantibodies is discussed as possible pathophysiologic mechanism in neonatal lupus. The symptoms, the onset, and recently published pathogenetic concepts are reviewed.

  8. The neonatal acoustic reflex.

    PubMed

    Weatherby, L A; Bennett, M J

    1980-01-01

    Probe tones from 220 Hz to 2 000 Hz were used to measure the static and dynamic acoustic impedance of 44 neonates. Acoustic reflex thresholds to broad band noise were obtained from every neonate tested when employing the higher frequency probe tones. The reflex threshold levels measured are similar to those of adults. The static impedance values are discussed to give a possible explanation of why reflex thresholds cannot be detected using conventional 220 Hz impedance bridges.

  9. Erythropoietin and Neonatal Neuroprotection

    PubMed Central

    Juul, Sandra E.; Pet, Gillian C.

    2015-01-01

    Certain groups of neonates are at high risk of developing long-term neurodevelopmental impairment (NDI) and might be considered candidates for neuroprotective interventions. This chapter will explore some of these high-risk groups, relevant mechanisms of brain injury, and specific mechanisms of cellular injury and death. The potential of erythropoietin (Epo) to act as a neuroprotective agent for neonatal brain injury will be discussed. Clinical trials of Epo neuroprotection in preterm and term infants are updated. PMID:26250911

  10. Neonatal renal vein thrombosis.

    PubMed

    Brandão, Leonardo R; Simpson, Ewurabena A; Lau, Keith K

    2011-12-01

    Neonatal renal vein thrombosis (RVT) continues to pose significant challenges for pediatric hematologists and nephrologists. The precise mechanism for the onset and propagation of renal thrombosis within the neonatal population is unclear, but there is suggestion that acquired and/or inherited thrombophilia traits may increase the risk for renal thromboembolic disease during the newborn period. This review summarizes the most recent studies of neonatal RVT, examining its most common features, the prevalence of acquired and inherited prothrombotic risk factors among these patients, and evaluates their short and long term renal and thrombotic outcomes as they may relate to these risk factors. Although there is some consensus regarding the management of neonatal RVT, the most recent antithrombotic therapy guidelines for the management of childhood thrombosis do not provide a risk-based algorithm for the acute management of RVT among newborns with hereditary prothrombotic disorders. Whereas neonatal RVT is not a condition associated with a high mortality rate, it is associated with significant morbidity due to renal impairment. Recent evidence to evaluate the effects of heparin-based anticoagulation and thrombolytic therapy on the long term renal function of these patients has yielded conflicting results. Long term cohort studies and randomized trials may be helpful to clarify the impact of acute versus prolonged antithrombotic therapy for reducing the morbidity that is associated with neonatal RVT. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Performance of The Meyer Binocular Telescope at Mt.Evans Observatory

    NASA Astrophysics Data System (ADS)

    Stencel, R. E.; Meyer, E. T.

    1999-05-01

    An unusual dual-aperture 28.5-inch, f/21 Ritchey-Chretien telescope has been installed in the recently upgraded University of Denver extreme high altitude observatory facility, atop 14,268 ft. Mount Evans in Colorado -- see 1994 BAAS 26:895 & 26:1321; 1998 BAAS 29:1272 & 30:1293; www.du.edu/ rstencel/MtEvans. Designed to optimize high spatial resolution imaging, the Meyer Binocular Telescope incorporates active thermal management of the telescope structure. The secondary mirror support elements are fabricated from INVAR and permit active tip-tilt and focusing capability. The optics were fabricated from Zerodur by Contraves USA, and each system has a measured total wavefront error less than 0.050 at 633nm. All optical surfaces are coated with a multi-layer dielectric enhanced silver, providing high reflectance from below 350nm to beyond 26 microns. During 1998, the first operational phases revealed that uncorrected image performance met image quality expectations. The dual Ritchey-Chretien optical systems were fabricated by Contraves USA. They incorporate a 0.7m F3 primary mirror and a 12cm, 7 power secondary mirror for a combined focal length of 14.92 meters. The Strehl ratio for both systems is approximately 94 noteworthy that these two telescopes are nearly identical in focal length and aperture thus simplifying the exchange of instrumentation between, and comparison of data obtained at, the two telescopes. All four mirrors are coated with a multilayer enhanced (protected) silver FSS 99 from Denton Vacuum. The low emissivity of this coating in the thermal infrared complement the low precipitable H2O levels measured at the Mount Evans site. The telescope control system has been designed to allow initial operation from an insulated control room. Long-term plans call for attended and remote operation from the University of Denver campus via direct microwave radio link, over a 35 mile direct line of sight. The University of Denver astronomy program is grateful to the

  12. Clinical trials in neonatal sepsis.

    PubMed

    Oeser, Clarissa; Lutsar, Irja; Metsvaht, Tuuli; Turner, Mark A; Heath, Paul T; Sharland, Mike

    2013-12-01

    Antibiotic licensing studies remain a problem in neonates. The classical adult clinical syndrome-based licensing studies do not apply to neonates, where sepsis is the most common infection. The main obstacle to conducting neonatal antibiotic trials is a lack of consensus on the definition of neonatal sepsis itself and the selection of appropriate endpoints. This article describes the difficulties of the clinical and laboratory definitions of neonatal sepsis and reviews the varying designs of previous neonatal sepsis trials. The optimal design of future trials of new antibiotics will need to be based on pharmacokinetic/pharmacodynamic parameters, combined with adequately powered clinical studies to determine safety and efficacy.

  13. Evans blue distribution in the rate brain after intracarotid injection with the blood-brain barrier intact and open to osmosis.

    PubMed

    Kozler, P; Pokorný, J

    2003-01-01

    Evans blue was applied to 12 rats by way of intracarotid injection into the common carotid artery or internal carotid artery both with the blood-brain barrier intact and after its mannitol-induced osmotic opening. For each type of application, a histological picture of Evans blue propagation through the brain was obtained by means of fluorescence microscopy. An assessment was made of the overall intensity of staining, and the ratio was established of the intra:extra-cellular Evans blue distribution in the cortex and hippocampus of both hemispheres. The histological picture obtained on injecting Evans blue into the internal carotic artery two minutes after the blood-brain barrier opening with mannitol can be seen as morphological evidence of the fact that the substance thus applied does have an effect on cell homeostasis since the intracellular share of Evans blue distribution is considerable.

  14. Patent ductus arteriosus in the premature neonate.

    PubMed

    Page, G G

    1985-03-01

    This article has reviewed current thought on the pathophysiology, medical management, and nursing implications of PDA in the premature newborn. The ductus arteriosus is a normal vascular channel that provides a route for blood flow to the descending aorta in the fetus; and it is an abnormal channel in the newborn that allows additional pulmonary blood flow to be shunted from the higher pressured aorta. Left heart volume overload and additional insults in connection with concurrent RDS and BPD were discussed. Current management for closure advocates indomethacin administration, and ligation, should indomethacin fail or be contraindicated. Continued patency with prostaglandin administration is the objective in cyanotic neonates with congenital heart disease and diminished pulmonary blood flow and in acyanotic neonates with aortic arch abnormalities that lead to decreased descending aortic flow. Nursing responsibilities encompass the well-being of the newborn as well as the family. The neonate must be assessed frequently for signs of cardiopulmonary deterioration. The neonate's responses to drug administration must be monitored for their effect on the ductus and the minimization of side effects. Care of the parents regarding support and information was discussed.

  15. Endogenous mycotic endophthalmitis in a dog with candiduria and Evans syndrome.

    PubMed

    Enders, Andrew; van der Woerdt, Alexandra; Donovan, Taryn

    2017-01-01

    This report describes the clinical presentation, diagnosis, histologic lesions, and outcome of endogenous mycotic endophthalmitis secondary to candiduria in a three-year-old female spayed Dachshund. The dog was being treated for Evans syndrome for one month prior to being diagnosed with candiduria and fibrinous uveitis OS. The left eye was enucleated due to secondary glaucoma, and the fungal urinary tract infection was treated successfully. Uveitis developed in the contralateral eye with relapse of the urinary tract infection in the following weeks. The right eye was medically managed until secondary glaucoma developed and was subsequently enucleated. Histopathology of both eyes showed evidence of endophthalmitis with intralesional fungal organisms, consistent with Candida spp. Ocular candidiasis is rare in dogs. To the authors' knowledge, this is the first report of endogenous mycotic endophthalmitis with concurrent candiduria in a dog. © 2016 American College of Veterinary Ophthalmologists.

  16. The influence of radioactive decay on actinide magnetic susceptibility measurements obtained using the Evans method.

    PubMed

    Autillo, Matthieu; Kaden, Peter; Geist, Andreas; Guerin, Laetitia; Moisy, Philippe; Berthon, Claude

    2014-05-14

    In order to explain the higher magnetic susceptibility of some aquo actinide ions than predicted by Hund's rules, the molar magnetic susceptibilities of two americium isotopes ((241)Am and (243)Am) were measured using the Evans method. The results obtained show a growing change in the magnetic susceptibility with α and also a β(-) activity increase in solution. β(-) particle effects appear to be stronger than radicals formed by α particles on the experimental values. The temperature dependence of Am(iii) magnetic susceptibility has been observed but from experiments carried out here, it appears to be difficult to prove whether this effect arises from radicals or β(-). Finally, magnetic susceptibilities of americium recorded in different media (HClO4, HCl, and HNO3) have been compared to alpha and beta emissions' impact.

  17. Spectroscopic study of the competitive interaction between streptomycin and Evans blue to bovine serum albumin

    NASA Astrophysics Data System (ADS)

    Huang, Jü-qin; Lv, Qing-luan; Wang, Huai You

    2011-12-01

    The mechanism of the competitive interaction of streptomycin and Evans blue (EB) to bovine serum albumin (BSA) has been studied by using both fluorimetry and spectrophtometry. Effects of pH, streptomycin and concentration of EB on the competitive interaction of streptomycin and EB were examined. A static fluorescence quenching process was confirmed in the light of Stern-Volmer plot. The test result showed that there were strong and weak binding sites on BSA molecule and the binding constant of EB-BSA complex and the number of binding site n were obtained. These facts revealed that the competitive interaction was occurred between EB and streptomycin, which can possibly provide useful message in investigation of the interaction of antibiotic with BSA.

  18. On the behavior of Bronsted-Evans-Polanyi Relations for Transition Metal Oxides

    SciTech Connect

    Vojvodic, Aleksandra

    2011-08-22

    Versatile Broensted-Evans-Polanyi (BEP) relations are found from density functional theory for a wide range of transition metal oxides including rutiles and perovskites. For oxides, the relation depends on the type of oxide, the active site and the dissociating molecule. The slope of the BEP relation is strongly coupled to the adsorbate geometry in the transition state. If it is final state-like the dissociative chemisorption energy can be considered as a descriptor for the dissociation. If it is initial state-like, on the other hand, the dissociative chemisorption energy is not suitable as descriptor for the dissociation. Dissociation of molecules with strong intramolecular bonds belong to the former and molecules with weak intramolecular bonds to the latter group. We show, for the prototype system La-perovskites, that there is a 'cyclic' behavior in the transition state characteristics upon change of the active transition metal of the oxide.

  19. Separation of Evans and Hiro currents in VDE of tokamak plasma

    NASA Astrophysics Data System (ADS)

    Galkin, Sergei A.; Svidzinski, V. A.; Zakharov, L. E.

    2014-10-01

    Progress on the Disruption Simulation Code (DSC-3D) development and benchmarking will be presented. The DSC-3D is one-fluid nonlinear time-dependent MHD code, which utilizes fully 3D toroidal geometry for the first wall, pure vacuum and plasma itself, with adaptation to the moving plasma boundary and accurate resolution of the plasma surface current. Suppression of fast magnetosonic scale by the plasma inertia neglecting will be demonstrated. Due to code adaptive nature, self-consistent plasma surface current modeling during non-linear dynamics of the Vertical Displacement Event (VDE) is accurately provided. Separation of the plasma surface current on Evans and Hiro currents during simulation of fully developed VDE, then the plasma touches in-vessel tiles, will be discussed. Work is supported by the US DOE SBIR Grant # DE-SC0004487.

  20. Fluorescence imaging of Evans blue extravasation into mouse brain induced by low frequency ultrasound with microbubble.

    PubMed

    Shen, Yuanyuan; Zhang, Aili; Guo, Jinxuan; Dan, Guo; Chen, Siping; Yu, Hao

    2014-01-01

    Blood-Brain Barrier (BBB) can be opened locally, noninvasively and reversibly by low frequency focused ultra-sound (FUS) in the presence of microbubbles. In this study, Evans blue (EB) dye extravasation across BBB was enhanced by 1 MHz FUS at acoustic pressure of 0.35 MPa in the presence of microbubbles at clinically comparable dosage. The spatial distribution of EB extravasation was visualized using fluorescence imaging method. The center region of BBB disruption area showed more enhanced fluorescence signal than the surrounding region in general. However, EB dye deposition was heterogeneous in the center region. The findings in this study indicated potential use of fluorescence imaging to evaluate large molecules delivery across BBB.

  1. VizieR Online Data Catalog: VFTS. B-type stars classification and RV (Evans+, 2015)

    NASA Astrophysics Data System (ADS)

    Evans, C. J.; Kennedy, M. B.; Dufton, P. L.; Howarth, I. D.; Walborn, N. R.; Markova, N.; Clark, J. S.; de Mink, S. E.; de Koter, A.; Dunstall, P. R.; Henault-Brunet, V.; Maiz Apellaniz, J.; McEvoy, C. M.; Sana, H.; Simon-Diaz, S.; Taylor, W. D.; Vink, J. S.

    2015-03-01

    All of the VFTS data discussed here were obtained using the Medusa-Giraffe mode of the Fibre Large Array Multi-Element Spectrograph (FLAMES) instrument on the Very Large Telescope (VLT). The Medusa fibres (which subtend 1.2" on the sky) were used to relay light from up to 130 targets simultaneously to the Giraffe spectrograph (see Pasquini et al., 2002Msngr.110....1P). Full details of the observational strategy and reduction of the data are given in Paper I (Evans et al., 2011A&A...530A.108E). In brief, the ESO Common Pipeline Library FLAMES recipes were used to undertake bias subtraction, fibre location, summed extractions of each object, division by a normalised flat-field, and wavelength calibration. Subsequent processing included correction of the spectra to the heliocentric frame, sky subtraction, and rejection of significant cosmic rays. (5 data files).

  2. The positive therapeutic effect in a patient of Evans syndrome combined with acute myocardial infarction

    PubMed Central

    Zhang, Yuwei; Zheng, Kai; Zheng, Miao; Liu, Qigong; Meng, Li

    2015-01-01

    Evans syndrome (ES) is a rare combination of autoimmune hemolytic anemia and thrombocytopenia. This case report details an old male ES patient with acute myocardial infarction. He was successfully treated by primary percutaneous coronary intervention in the case of low hemoglobin level (60 g/L). Considering ES recurrence after surgery, he was given human immunoglobulin, methyl prednisolone and TPO treatment. On the basis of his platelet count, the patient was required to take only one anti-platelet drug or stop all anti-platelet drugs. To the best of our knowledge, this is the first report of ES with AMI. This case suggests that primary PCI can be a useful therapeutic strategy even if patient has low hemoglobin level, but careful balance between anti-platelet therapy and efforts to raise platelet count are needed after surgery. PMID:26309630

  3. Incorporation of the Deshpande-Evans mechanism-based damage model into the EPIC code

    NASA Astrophysics Data System (ADS)

    Holmquist, Timothy J.; Johnson, Gordon R.

    2012-03-01

    This article presents the incorporation of a mechanism-based failure model into the EPIC code. The model was developed by Deshpande and Evans (DE) and is based on micromechanics and wing-crack theory. The model includes the effects of flaw size, flaw density, fracture toughness, friction, crack shape, and crack growth rate. It is also fully 3-dimensional and covers both compression and tension. Specifically, this work incorporates the DE damage model into the Johnson-Holmquist- Beissel (JHB) ceramic model providing a micromechanical approach for computing damage. A discussion of the DE damage model and its incorporation into the JHB model is provided. Computations are presented for two ballistic impact experiments into 99.5% - Al2O3 ceramic including some parametric effects.

  4. Incorporation of the Deshpande-Evans Mechanism-Based Damage Model into the EPIC Code

    NASA Astrophysics Data System (ADS)

    Holmquist, Timothy

    2011-06-01

    This article presents the incorporation of a mechanism-based failure model into the EPIC code. The model was developed by Deshpande and Evans (DE) and is based on micromechanics and wing-crack theory. The model includes the effects of flaw size, flaw density, fracture toughness, friction, crack shape, and crack growth rate. It is also fully 3-dimensional and covers both compression and tension. This work incorporates the DE model into the Johnson-Holmquist-Beissel (JHB) ceramic model and provides an optional, micromechanical, approach for computing damage. A discussion of the DE damage model including the theory and its incorporation into the JHB model is provided. Computations are also presented for several ballistic impact experiments into 99.5 alumina ceramic including some parametric effects.

  5. F-18 simulation with Simulation Group Lead Martha Evans at the controls

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Simulation Group Leader Martha Evans is seen here at the controls of the F-18 aircraft simulator at NASA's Dryden Flight Research Center, Edwards, California. Simulators offer a safe and economical alternative to actual flights to gather data, as well as being excellent facilities for pilot practice and training. The highly modified F-18 airplane flew 383 flights over a nine year period and demonstrated concepts that greatly increase fighter maneuverability. Among concepts proven in the aircraft is the use of paddles to direct jet engine exhaust in cases of extreme altitudes where conventional control surfaces lose effectiveness. Another concept, developed by NASA Langley Research Center, is a deployable wing-like surface installed on the nose of the aircraft for increased right and left (yaw) control on nose-high flight angles.

  6. Photoacoustic imaging of brain perfusion on albino rats by using evans blue as contrast agent.

    PubMed

    Pilatou, M C; Marani, E; de Mul, F F M; Steenbergen, W

    2003-10-01

    The visualization of the brain vascular system could be of great importance for studying its functionality and for diagnosing possible disorders. In this paper we report the use of photoacoustics for imaging brain perfusion on Albino rats in vivo and post mortem. The measurements on the animals were direct on the skin surface. The blood perfusion on skull cartilage was imaged and 2D slices were constructed by using a beamforming algorithm. From the images representation the Interactive Data Language (IDL, Research System Inc.) was used. We also investigated the possibility of using the Evans Blue dye as a substitute of blood for imaging brain structures in vitro. The breakdown of the dye under pulsed laser irradiation was studied and the energy under which this effect occurs was calculated for the wavelength of 532 nm.

  7. Transient electroluminescence under double rectangular voltage pulses in light-emitting devices based on Evans blue

    NASA Astrophysics Data System (ADS)

    Roy, S.; Pal, A. J.

    2000-05-01

    Transient electroluminescence (EL) characteristics of light emitting devices fabricated with Evans blue have been studied. A sequence of two rectangular voltage pulses separated by a time delay has been applied. The voltage amplitude and the separation between the pulses have been varied, and EL intensity has been measured. These studies have helped us to understand the behaviour of the space charges accumulated at the interfaces of the active layer with two electrodes. The variation of EL intensity during the second pulse for different separation times gives information regarding the relaxation process of accumulated charges in the device. The EL under a square-wave ac voltage further supports the role of accumulated charge in device operation.

  8. Stable Evans Blue Derived Exendin-4 Peptide for Type 2 Diabetes Treatment.

    PubMed

    Liu, Yi; Wang, Guohao; Zhang, Huimin; Ma, Ying; Lang, Lixin; Jacobson, Orit; Kiesewetter, Dale O; Zhu, Lei; Gao, Shi; Ma, Qingjie; Chen, Xiaoyuan

    2016-01-20

    In the treatment of type 2 diabetes mellitus, it is very important to develop therapeutics with prolonged circulation half-life. Exendin-4 is a glucagon like peptide-1 receptor (GLP-1R) agonist that has been modified in different ways for imaging insulinoma and for treating type-2 diabetes. In this work, we synthesized a maleimide derivative of truncated Evans blue dye (MEB-C3-Mal) to conjugate with (Cys(40))exendin-4 to obtain a highly stable MEB-C3-(Cys(40))exendin-4 (denoted as Abextide II). Through in situ binding with endogenous albumin, Abextide II lowers blood glucose level and prolongs the hypoglycemic effect in a type 2 diabetes mouse model more than the FDA approved Albiglutide.

  9. Evans blue dye-enhanced capillary-resolution photoacoustic microscopy in vivo

    NASA Astrophysics Data System (ADS)

    Yao, Junjie; Maslov, Konstantin; Hu, Song; Wang, Lihong V.

    2009-09-01

    Complete and continuous imaging of microvascular networks is crucial for a wide variety of biomedical applications. Photoacoustic tomography can provide high resolution microvascular imaging using hemoglobin within red blood cells (RBCs) as an endogenic contrast agent. However, intermittent RBC flow in capillaries results in discontinuous and fragmentary capillary images. To overcome this problem, we use Evans blue (EB) dye as a contrast agent for in vivo photoacoustic imaging. EB has strong optical absorption and distributes uniformly in the blood stream by chemically binding to albumin. With the help of EB, complete and continuous microvascular networks--especially capillaries--are imaged. The diffusion dynamics of EB leaving the blood stream and the clearance dynamics of the EB-albumin complex are also quantitatively investigated.

  10. Spectroscopic study of the competitive interaction between streptomycin and Evans blue to bovine serum albumin.

    PubMed

    Huang, Jü-qin; Lv, Qing-luan; Wang, Huai You

    2011-12-01

    The mechanism of the competitive interaction of streptomycin and Evans blue (EB) to bovine serum albumin (BSA) has been studied by using both fluorimetry and spectrophtometry. Effects of pH, streptomycin and concentration of EB on the competitive interaction of streptomycin and EB were examined. A static fluorescence quenching process was confirmed in the light of Stern-Volmer plot. The test result showed that there were strong and weak binding sites on BSA molecule and the binding constant of EB-BSA complex and the number of binding site n were obtained. These facts revealed that the competitive interaction was occurred between EB and streptomycin, which can possibly provide useful message in investigation of the interaction of antibiotic with BSA. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Evans blue dye-enhanced capillary-resolution photoacoustic microscopy in vivo.

    PubMed

    Yao, Junjie; Maslov, Konstantin; Hu, Song; Wang, Lihong V

    2009-01-01

    Complete and continuous imaging of microvascular networks is crucial for a wide variety of biomedical applications. Photoacoustic tomography can provide high resolution microvascular imaging using hemoglobin within red blood cells (RBCs) as an endogenic contrast agent. However, intermittent RBC flow in capillaries results in discontinuous and fragmentary capillary images. To overcome this problem, we use Evans blue (EB) dye as a contrast agent for in vivo photoacoustic imaging. EB has strong optical absorption and distributes uniformly in the blood stream by chemically binding to albumin. With the help of EB, complete and continuous microvascular networks--especially capillaries--are imaged. The diffusion dynamics of EB leaving the blood stream and the clearance dynamics of the EB-albumin complex are also quantitatively investigated.

  12. A Gallavotti-Cohen-Evans-Morriss Like Symmetry for a Class of Markov Jump Processes

    NASA Astrophysics Data System (ADS)

    Barato, Andre Cardoso; Chetrite, Raphaël; Hinrichsen, Haye; Mukamel, David

    2012-01-01

    We investigate a new symmetry of the large deviation function of certain time-integrated currents in non-equilibrium systems. The symmetry is similar to the well-known Gallavotti-Cohen-Evans-Morriss-symmetry for the entropy production, but it concerns a different functional of the stochastic trajectory. The symmetry can be found in a restricted class of Markov jump processes, where the network of microscopic transitions has a particular structure and the transition rates satisfy certain constraints. We provide three physical examples, where time-integrated observables display such a symmetry. Moreover, we argue that the origin of the symmetry can be traced back to time-reversal if stochastic trajectories are grouped appropriately.

  13. Calibration of the Barnes-Evans Relation Using Interferometric Observations of Cepheids

    NASA Astrophysics Data System (ADS)

    Nordgren, Tyler E.; Lane, B. F.; Hindsley, R. B.; Kervella, P.

    2002-06-01

    Direct diameter observations of Cepheid variables are used to calibrate the Barnes-Evans Cepheid surface brightness relation. Fifty-nine separate Cepheid diameter measurements from four different optical interferometers are used to calculate surface brightnesses as a function of magnitude and color. The linear fit to Cepheid surface brightness versus color is in excellent agreement with functions in the literature found using interferometric observations of nonvariable giant and supergiant stars. Using these relations, the distance is calculated to δ Cephei, for which an independent distance is known from trigonometric parallax. The distance from the relation in this paper differs from that derived by the previously published relation by 4% but is still marginally within the combined errors. Both distances are well within the errors of the distance derived from trigonometric parallax.

  14. Identifying autoimmune lymphoproliferative syndrome in children with Evans syndrome: a multi-institutional study.

    PubMed

    Seif, Alix E; Manno, Catherine S; Sheen, Cecilia; Grupp, Stephan A; Teachey, David T

    2010-03-18

    Autoimmune lymphoproliferative syndrome (ALPS) is a disorder of abnormal lymphocyte survival caused by dysregulation of the Fas apoptotic pathway. Clinical manifestations of ALPS include autoimmune cytopenias, organomegaly, and lymphadenopathy. These findings overlap with Evans syndrome (ES), defined by presence of at least 2 autoimmune cytopenias. We hypothesized a subset of patients with ES have ALPS and tested 45 children at 22 institutions, measuring peripheral blood double-negative T cells (DNTs) and Fas-mediated apoptosis. ALPS was diagnosed in 47% of patients tested. Markedly elevated DNTs (> or = 5%) were a strong predictor of ALPS (positive predictive value = 94%), whereas no patients with DNTs less than 2.5% had ALPS on apoptosis testing. Severity of cytopenias and elevated immunoglobulin levels also predicted ALPS. This is the largest published series describing children with ES and documents a high rate of ALPS among pediatric ES patients. These data suggest that children with ES should be screened for ALPS with DNTs.

  15. Rituximab resistant evans syndrome and autoimmunity in Schimke immuno-osseous dysplasia

    PubMed Central

    2011-01-01

    Autoimmunity is often observed among individuals with primary immune deficiencies; however, the frequency and role of autoimmunity in Schimke immuno-osseous dysplasia (SIOD) has not been fully assessed. SIOD, which is caused by mutations of SMARCAL1, is a rare autosomal recessive disease with its prominent features being skeletal dysplasia, T cell deficiency, and renal failure. We present a child with severe SIOD who developed rituximab resistant Evans syndrome (ES). Consistent with observations in several other immunodeficiency disorders, a review of SIOD patients showed that approximately a fifth of SIOD patients have some features of autoimmune disease. To our best knowledge this case represents the first patient with SIOD and rituximab resistant ES and the first study of autoimmune disease in SIOD. PMID:21914180

  16. Measurement of vascular permeability in spinal cord using Evans Blue spectrophotometry and correction for turbidity.

    PubMed

    Warnick, R E; Fike, J R; Chan, P H; Anderson, D K; Ross, G Y; Gutin, P H

    1995-05-01

    Vascular permeability can be visualized by Evans Blue (EB) extravasation and quantified by spectrophotometry after formamide extraction of the tissue. However, formamide extracts show significant turbidity, which may contribute to the total optical density at the wavelength of measurement (e.g., 620 lambda). We developed a simple method for estimating the component of the total optical density of a dyed specimen contributed by turbidity. Our method, which uses a determination of turbidity made at another point of the light spectrum (740 lambda), was more precise than two other EB quantification techniques. We therefore recommend it for individual correction of formamide extracts of spinal cord specimens. The application of this technique to the brain remains to be determined.

  17. The Immature Stages and Shelter Building Behavior of Falgo Jeconia Ombra Evans, 1955 in eastern Ecuador (Lepidoptera: Hesperiidae: Hesperiinae)

    PubMed Central

    Greeney, Harold F.; Warren, Andrew D.

    2009-01-01

    We describe the immature stages and shelter building behavior of Falga jeconia ombra Evans, 1955 from eastern Ecuador. Chusquea scandens (Poaceae, Bambusoidea) is the larval food plant. Larvae in all stadia build shelters and forcibly eject frass with the aid of an anal comb. Later instars possess an eversible prothoracic “neck” gland. Larvae are associated with moving water. PMID:19613872

  18. ATRAZINE INCREASES DIMETHYLBENZ[A]ANTHRACENE-INDUCED MAMMARY TUMOR INCIDENCE IN LONG EVANS OFFSPRING EXPOSED IN UTERO

    EPA Science Inventory

    ATRAZINE INCREASES DIMETHYLBENZ[A]ANTHRACENE-INDUCED MAMMARY TUMOR INCIDENCE IN LONG EVANS OFFSPRING EXPOSED IN UTERO.

    SE Fenton and CC Davis

    Reproductive Toxicology Division, NHEERL, ORD, USEPA, Durham, NC, USA

    Recently, we found that ATR exposure during ma...

  19. Mammary gland development and response to prenatal atrazine exposure in the Sprague Dawley and Long-Evans rats.

    EPA Science Inventory

    Mammary gland (MG) tumor development in Sprague Dawley (SD) rats is increased by longterm dietary exposure to the chlorotriazine herbicide atrazine (ATR). ATR is proposed to cause these changes in the adult SD rat by altering hormonally-regulated estrous cyclicity. In Long-Evans...

  20. Ann Hutchinson (as subject), Dr. Joan Vernikos (R), Dee O'Hara (L), J. Evans and E. Lowe pose for

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Ann Hutchinson (as subject), Dr. Joan Vernikos (R), Dee O'Hara (L), J. Evans and E. Lowe pose for pictures in the NASA Magazine aritcle 'How it Feels to be a Human Test Subject' as they prepare for a bed rest study to simulate the efects of microgravity on the human body.

  1. EXPOSURE PARAMETERS NECESSARY FOR DELAYED PUBERTY AND MAMMARY GLAND DEVELOPMENT IN LONG-EVANS RATS EXPOSED IN UTERO TO ATRAZINE

    EPA Science Inventory

    Exposure Parameters Necessary For Delayed Puberty And Mammary Gland Development In Long-Evans Rats Exposed In Utero To Atrazine

    Jennifer L. Rayner1, 2, Carmen Wood2, and Suzanne E. Fenton2

    1 Department of Environmental Sciences and Engineering, School of Public Heal...

  2. An aerial radiological survey of the Evans Area, US Army Communications-Electronics Command, Fort Monmouth, New Jersey

    SciTech Connect

    Maurer, R.J.

    1989-12-01

    An aerial radiological survey was conducted over the Evans Area, US Army Communications-Electronics Command, Fort Monmouth, New Jersey, during the period November 14--18, 1988. The purposes of the survey were to document the terrestrial gamma environment of the Evans site and surrounding area and to determine if there had been any radiological impact on the area due to past laboratory operations. The results of the aerial survey are reported as inferred radiation exposure rates at 1 meter above ground level in the form of a contour map. The aerial data were compared to ground-based benchmark'' exposure rate measurements and radionuclide assay of soil samples obtained at sites outside the survey perimeter. Similar ground-based measurements were also made at several locations on the Evans site and at the bank of the Shark River bordering the Evans Area. No evidence for contamination was identified by either radionuclide assay of soil samples or the aerial survey. 6 refs., 5 figs., 2 tabs.

  3. ATRAZINE INCREASES DIMETHYLBENZ[A]ANTHRACENE-INDUCED MAMMARY TUMOR INCIDENCE IN LONG EVANS OFFSPRING EXPOSED IN UTERO

    EPA Science Inventory

    ATRAZINE INCREASES DIMETHYLBENZ[A]ANTHRACENE-INDUCED MAMMARY TUMOR INCIDENCE IN LONG EVANS OFFSPRING EXPOSED IN UTERO.

    SE Fenton and CC Davis

    Reproductive Toxicology Division, NHEERL, ORD, USEPA, Durham, NC, USA

    Recently, we found that ATR exposure during ma...

  4. First record of the leafhopper genus Soractellus Evans, 1966 (Hemiptera: Cicadellidae: Deltocephalinae) from China, with description of a new species.

    PubMed

    Xing, Ji-Chun; Li, Zi-Zhong

    2014-03-28

    The genus Soractellus Evans, 1966 is reported for the first time based on a new species, Soractellus jianfengensis sp. nov., here described and illustrated from China. A key is given to distinguish all species of the genus. The type specimens of the new species are deposited in the Institute of Entomology, Guizhou University, Guiyang, China (GUGC).

  5. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND IT'S BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS.
    Rolondo R. Enoch2, Sara N. Greiner 1, Geri L. Youngblood 1, Christine C. Davis 1, and Suzanne E. Fenton 1
    1 U.S. Environmental Protection Agency, ORD, ...

  6. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS.
    Rolondo R. Enoch2, Sara N. Greiner 1, Geri L. Youngblood 1, Christine C. Davis 1, and Suzanne E. Fenton 1
    1 U.S. Environmental Protection Agency, ORD, ...

  7. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND IT'S BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS. Suzanne E. Fenton 1, Sara N. Greiner 1, Geri L. Youngblood 1 and Christine C. Davis 1
    1 U.S. Environmental Protection Agency, Reproductive Toxicology Divi...

  8. The immature stages and shelter building behavior of Falgo Jeconia Ombra Evans, 1955 in eastern Ecuador (Lepidoptera: Hesperiidae: Hesperiinae).

    PubMed

    Greeney, Harold F; Warren, Andrew D

    2009-01-01

    We describe the immature stages and shelter building behavior of Falga jeconia ombra Evans, 1955 from eastern Ecuador. Chusquea scandens (Poaceae, Bambusoidea) is the larval food plant. Larvae in all stadia build shelters and forcibly eject frass with the aid of an anal comb. Later instars possess an eversible prothoracic "neck" gland. Larvae are associated with moving water.

  9. A PHYSIOLOGICALLY-BASED PHARMACOKINETIC MODEL FOR TOLUENE IN THE LONG EVANS RAT: BODY COMPOSITION AND PHYSICAL ACTIVITY.

    EPA Science Inventory

    A physiologically-based pharmacokinetic (PBPK) model for inhaled toluene was developed for Long-Evans rats as a component of an exposure-dose-response (EDR) model for volatile organic compounds. The PBPK model was needed to link airborne toluene exposure to its concentration in b...

  10. A PHYSIOLOGICALLY-BASED PHARMACOKINETIC MODEL FOR TOLUENE IN THE LONG EVANS RAT: BODY COMPOSITION AND PHYSICAL ACTIVITY.

    EPA Science Inventory

    A physiologically-based pharmacokinetic (PBPK) model for inhaled toluene was developed for Long-Evans rats as a component of an exposure-dose-response (EDR) model for volatile organic compounds. The PBPK model was needed to link airborne toluene exposure to its concentration in b...

  11. Mammary gland development and response to prenatal atrazine exposure in the Sprague Dawley and Long-Evans rats.

    EPA Science Inventory

    Mammary gland (MG) tumor development in Sprague Dawley (SD) rats is increased by longterm dietary exposure to the chlorotriazine herbicide atrazine (ATR). ATR is proposed to cause these changes in the adult SD rat by altering hormonally-regulated estrous cyclicity. In Long-Evans...

  12. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS.
    Rolondo R. Enoch2, Sara N. Greiner 1, Geri L. Youngblood 1, Christine C. Davis 1, and Suzanne E. Fenton 1
    1 U.S. Environmental Protection Agency, ORD, ...

  13. IN UTERO EXPOSURE TO ATRAZINE INDUCES DELAYED PUBERTY OF LONG EVANS RATS: DAM-MEDIATED EFFECTS IN FEMALES

    EPA Science Inventory

    IN UTERO EXPOSURE TO ATRAZINE INDUCES DELAYED PUBERTY OF LONG EVANS RATS: DAM-MEDIATED EFFECTS IN FEMALES.

    J L Rayner1 and S E Fenton2.

    1 University of North Carolina at Chapel Hill, School of Public Health, Chapel Hill, NC, and 2 Reproductive Toxicology Divisio...

  14. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND IT'S BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS.
    Rolondo R. Enoch2, Sara N. Greiner 1, Geri L. Youngblood 1, Christine C. Davis 1, and Suzanne E. Fenton 1
    1 U.S. Environmental Protection Agency, ORD, ...

  15. EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND ITS METABOLITES IN MALE LONG EVANS RATS

    EPA Science Inventory

    TITLE: EFFECTS FROM GESTATIONAL EXPOSURE TO A MIXTURE OF ATRAZINE AND IT'S BIOLOGICAL METABOLITES IN MALE LONG EVANS RATS. Suzanne E. Fenton 1, Sara N. Greiner 1, Geri L. Youngblood 1 and Christine C. Davis 1
    1 U.S. Environmental Protection Agency, Reproductive Toxicology Divi...

  16. EXPOSURE PARAMETERS NECESSARY FOR DELAYED PUBERTY AND MAMMARY GLAND DEVELOPMENT IN LONG-EVANS RATS EXPOSED IN UTERO TO ATRAZINE

    EPA Science Inventory

    Exposure Parameters Necessary For Delayed Puberty And Mammary Gland Development In Long-Evans Rats Exposed In Utero To Atrazine

    Jennifer L. Rayner1, 2, Carmen Wood2, and Suzanne E. Fenton2

    1 Department of Environmental Sciences and Engineering, School of Public Heal...

  17. Ann Hutchinson (as subject), Dr. Joan Vernikos (R), Dee O'Hara (L), J. Evans and E. Lowe pose for

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Ann Hutchinson (as subject), Dr. Joan Vernikos (R), Dee O'Hara (L), J. Evans and E. Lowe pose for pictures in the NASA Magazine aritcle 'How it Feels to be a Human Test Subject' as they prepare for a bed rest study to simulate the efects of microgravity on the human body.

  18. Radar-derived hydrological conditions beneath Evans Ice Stream, West Antarctica

    NASA Astrophysics Data System (ADS)

    Ashmore, D. W.; Bingham, R. G.; Hindmarsh, R. C.

    2012-12-01

    Airborne ice-penetrating radar (radio-echo sounding) is the most efficient method for investigating subglacial environments across polar ice-sheets. Theoretically, analyses of the shape and amplitude of the basal reflector can yield physical information on subglacial conditions. Most notably, due to the high relative permittivity of liquid water a high amplitude reflection indicates a temperate (unfrozen) bed, whose diagnosis is pertinent for understanding controls on ice dynamics and, in particular, tributary and fast-flow phenomena. However exploiting datasets in this way remains difficult as consistent algorithms for the quantitative analysis of basal reflectors are yet to be established, with perhaps the greatest difficulty being posed by characterising how the ice itself attenuates the radar signal. Here we consider the above problem using airborne ice-penetrating radar data acquired over Evans Ice Stream, West Antarctica, in 2006/07, using the British Antarctic Survey 150 MHz centre-frequency radar (PASIN). Evans Ice Stream drains a significant portion of the Weddell Sea Sector of West Antarctica and remains comparatively understudied. Five distinct tributaries converge in a large steep-sided basin to form a wide and fast flowing trunk which flows to a sinuous and tidally influenced grounding line. We discuss the analysis of the peak amplitude of the basal reflection, a specularity proxy and the application of an englacial attenuation correction using temperatures from a 3D numerical model. Coupled with qualitative indicators of subglacial conditions we suggest the spatial variability of basal conditions and discuss the associated sources of potential error.

  19. First Light Achieved at the new Mt.Evans High Altitude Observatory

    NASA Astrophysics Data System (ADS)

    Stencel, R. E.

    1997-12-01

    During August 1997, first light images were obtained with the new Meyer Binocular Telescope, a twin 0.72 meter RC system, located at the Meyer- Womble Observatory atop 14,268 ft Mt.Evans, Colorado. The site is along a treeless high ridge which frequently enjoys laminar airflow and good seeing. The telescope and building also include thermal and airflow management systems for seeing optimization. Finally, a 5 element adaptive optics system that is being tested at Yerkes Observatory, should be able to correct the native seeing to nearly the limit of optical performance. For details on all of the above, please refer to my website: www.du.edu/ rstencel. The high altitude of Mt.Evans makes it ideal for mid-infrared studies, and we anticipate pursuing mid-IR imaging and spectroscopy from this site. Mark 2 of our TNTCAM (Klebe et al.-this meeting) is now in design stage, thanks to an NSF MRI grant. The spectrometer, TGIRS (Creech-Eakman et al. 1996 BAAS 28: 1372) has also achieved first light in the lab. We plan to use both at the new mountaintop facility. Another interesting feature of the new observatory is its photovoltaic energy supply for continuous power, sponsored in part by the Renewable Energy Trust, National Renewable Energy Lab and the Colorado Office of Energy Conservation. Denver University is interested in forming partnerships with other programs in order to make best use of this new resource for educational research in astronomy and astrophysics. This can include REU-style student summer visits, instrument testing and/or observational studies. I am pleased to acknowledge sponsorship by the Estate of William Herschel Womble, and the Meyer Foundation.

  20. Development of obesity in the Otsuka Long-Evans Tokushima Fatty rat.

    PubMed

    Schroeder, Mariana; Zagoory-Sharon, Orna; Shbiro, Liat; Marco, Asaf; Hyun, Jayson; Moran, Timothy H; Bi, Sheng; Weller, Aron

    2009-12-01

    Understanding the early factors affecting obesity development in males and females may help to prevent obesity and may lead to the discovery of more effective treatments for those already obese. The Otsuka Long-Evans Tokushima Fatty (OLETF) rat model of obesity is characterized by hyperphagia-induced obesity, due to a spontaneous lack of CCK(1) receptors. In the present study, we focused on the behavioral and physiological aspects of obesity development from weaning to adulthood. We examined body weight, feeding efficiency, fat pad [brown, retroperitoneal, inguinal and epydidimal (in males)] weight, inguinal adipocyte size and number, leptin and oxytocin levels, body mass index, waist circumference, and females' estrous cycle structure. In the males, central hypothalamic gene expression was also examined. OLETF rats presented overall higher fat and leptin levels, larger adipocytes, and increased waist circumference and BMI from weaning until adulthood, compared with controls. Analysis of developmental patterns of gene expression for hypothalamic neuropeptides revealed peptide-specific patterns that may underlie or be a consequence of the obesity development. Analysis of the developmental trajectories toward obesity within the OLETF strain revealed that OLETF females developed obesity in a more gradual manner than the males, presenting delayed obesity-related "turning points," with reduced adipocyte size but larger postweaning fat pads and increased adipocyte hyperplasia compared with the males. Intake decrease in estrus vs. proestrus was significantly less in OLETF vs. Long-Evans Tokushima Otsuka females. The findings highlight the importance of using different sex-appropriate approaches to increase the efficacy of therapeutic interventions in the treatment and prevention of chronic early-onset obesity.

  1. Defining Neonatal Sepsis

    PubMed Central

    Wynn, James L.

    2016-01-01

    Purpose of the review Although infection rates have modestly decreased in the neonatal intensive care unit (NICU) as a result of ongoing quality improvement measures, neonatal sepsis remains a frequent and devastating problem among hospitalized preterm neonates. Despite multiple attempts to address this unmet need, there have been minimal advances in clinical management, outcomes, and accuracy of diagnostic testing options over the last three decades. One strong contributor to a lack of medical progress is a variable case definition of disease. The inability to agree on a precise definition greatly reduces the likelihood of aligning findings from epidemiologists, clinicians, and researchers, which, in turn, severely hinders progress towards improving outcomes. Recent findings Pediatric consensus definitions for sepsis are not accurate in term infants and are not appropriate for preterm infants. In contrast to the defined multi-stage criteria for other devastating diseases encountered in the NICU (e.g., bronchopulmonary dysplasia), there is significant variability in the criteria used by investigators to substantiate the diagnosis of neonatal sepsis. Summary The lack of an accepted consensus definition for neonatal sepsis impedes our efforts towards improved diagnostic and prognostic options as well as accurate outcomes information for this vulnerable population. PMID:26766602

  2. Neonatal Haemophilus influenzae infections.

    PubMed Central

    Takala, A K; Pekkanen, E; Eskola, J

    1991-01-01

    Nine cases of neonatal Haemophilus influenzae septicaemia were recorded in Finland during 1985-9; incidence was 2.8/100,000 live births, and 1.6% of all cases of neonatal septicaemia. The onset of the disease was early in all cases, ranging from 0-6 hours after delivery. Seven of the infants were preterm and three died (overall mortality 33%). H influenzae was isolated from blood in seven of the cases, and in two neonates with clinical signs of septicaemia it was found on several surface sites and the placenta. One of the eight strains of H influenzae was capsular type b and biotype I, the rest being non-typable--a distribution similar to those previously reported. Four of the uncapsulated strains were of biotype III, and three were of biotype II. None of the strains of H influenzae was of biotype IV, which has been reported to be characteristic of neonatal and genital isolates of H influenzae. All nine mothers had some sign of infection at the time of or shortly after delivery. H influenzae was isolated from five mothers: from the blood (n = 1) or from the placenta or cervix (n = 4). The use of intrauterine devices may be a possible risk factor for neonatal H influenzae infections; two of the mothers had such devices in place during their pregnancies. PMID:2025040

  3. Monitoring neonatal seizures.

    PubMed

    Boylan, Geraldine B; Stevenson, Nathan J; Vanhatalo, Sampsa

    2013-08-01

    Neonatal seizures are a neurological emergency and prompt treatment is required. Seizure burden in neonates can be very high, status epilepticus a frequent occurrence, and the majority of seizures do not have any clinical correlate. Detection of neonatal seizures is only possible with continuous electroencephalogram (EEG) monitoring. EEG interpretation requires special expertise that is not available in most neonatal intensive care units (NICUs). As a result, a simplified method of EEG recording incorporating an easy-to-interpret compressed trend of the EEG output (amplitude integrated EEG) from one of the EEG output from one or two channels has emerged as a popular way to monitor neurological function in the NICU. This is not without limitations; short duration and low amplitude seizures can be missed, artefacts are problematic and may mimic seizure-like activity and only a restricted area of the brain is monitored. Continuous multichannel EEG is the gold standard for detecting seizures and monitoring response to therapy but expert interpretation of the EEG output is generally not available. Some centres have set up remote access for neurophysiologists to the cot-side EEG, but reliable interpretation is wholly dependent on the 24 h availability of experts, an expensive solution. A more practical solution for the NICU without such expertise is an automated seizure detection system. This review outlines the current state of the art regarding cot-side monitoring of neonatal seizures in the NICU.

  4. Prenatal cocaine exposure and neonatal/infant outcomes.

    PubMed

    Cambell, Shelly

    2003-01-01

    Illegal drug use throughout the nation is a problem of epidemic proportion. Of particular concern is drug use among pregnant women. In most cases, these women have little hope of achieving a better life for themselves or their children. Illegal drugs, cocaine in particular, can have devastating effects on the neonate. These effects can last well into childhood and can exhibit themselves in academic, social, and family situations. Challenges for the neonatal nurse include early identification of these infants and use of available resources. This article addresses prenatal cocaine use and support services for drug-dependent women, effects of cocaine during the neonatal period, possible neonatal and infant outcomes, and implications for nursing practice.

  5. Natal and neonatal teeth.

    PubMed

    Farsi, Deema J; Ahmed, Muhammad M

    2014-05-01

    Natal teeth (teeth present at birth) and neonatal teeth (teeth observed in the first 30 days of life) are uncommon. They may cause feeding problems and ulcerations on the ventral surface of the tongue. They can also be alarming to parents and cause discomfort with breastfeeding. A review of literature was conducted to review their etiology, significance, and clinical features with special emphasis on the complications and management. The opportunity of establishing a dental home through the early dental visits was highlighted. Furthermore, this case report details the examination and management of a 24-hour old neonate with 2 neonatal teeth. Natal teeth, although uncommon, are best referred to pediatric dentists for investigation and management.

  6. Neonatal solid tumors.

    PubMed

    Chandrasekaran, Aravindan

    2017-07-11

    Neonatal tumors are different from tumors of the older children and knowledge gained from treating older children can not be extrapolated to neonates. Neonates have immature physiology and their haematopoietic and immune systems are not fully developed and the response to therapy is unpredictable. Hence it is imperative to study these tumors as separate entity. The aim of this study is to analyse this rare set of tumors in terms of their incidence, clinical features and management. All babies admitted in our hospital with tumors from January, 2011 to January 2016 were studied. Tumor-like conditions like haemangioma, lymphangioma and hamartomas were included. The age, sex distribution, type of tumor and management were studied. A total of 51 cases were registered out of which, 29 cases were haemangiomas and lymphangiomas. Of remaining 20 cases, 5 were benign ovarian cysts, 3 were neuroblastomas, 3 were congenital fibrosarcomas, 3 were sacrococcygeal teratomas. Wilm's tumor, congenital mesoblastic nephroma, haemangioendothelioma of liver and others formed the remaining six cases. Our study insists that the neonatal tumors are distinct subset of pediatric tumors, requiring careful selection of treatment modalities and most of the solid tumors can be successfully managed if diagnosed and treated early. Neonatal tumors are defined as tumors which are diagnosed before the first month of life. Some of them can be congenital (present at birth). Neonatal tumors are different from tumors in older children in terms of etiopathogenesis, behavior and response to therapy as well as long-term outcomes. Copyright © 2017. Published by Elsevier B.V.

  7. The body comes to family therapy: Treatment of a school-aged boy with hyperventilation-induced non-epileptic seizures.

    PubMed

    Kozlowska, Kasia; Chudleigh, Catherine; Elliott, Bronwen; Landini, Andrea

    2016-10-01

    We present the case of a 10-year-old boy, Evan, where a knock to the head activated memories of past bullying, causing intense distress, activation of the body's stress-regulation systems and recurrent hospital presentations with hyperventilation-induced non-epileptic seizures. We describe the initial assessment session that enabled Evan and his family to understand the context for Evan's non-epileptic seizures, to engage with the therapeutic team and to collaborate in the implementation of a mind-body multimodal family-based intervention. Once the physical symptoms had been addressed therapeutically, we explored possible dangers within the family and school systems and we worked with Evan and his family to increase his ability to access comfort and protection from his parents. Our short hospital intervention highlighted the importance of ongoing therapeutic work with Evan and the family and laid the foundation stones for the next part of the family's therapeutic journey. © The Author(s) 2015.

  8. Neonatal brucellosis: A case report.

    PubMed

    Alnemri, Abdul Rahman M; Hadid, Adnan; Hussain, Shaik Asfaq; Somily, Ali M; Sobaih, Badr H; Alrabiaah, Abdulkarim; Alanazi, Awad; Shakoor, Zahid; AlSubaie, Sarah; Meriki, Naema; Kambal, Abdelmageed M

    2017-02-28

    Although brucellosis is not uncommon in Saudi Arabia, neonatal brucellosis has been infrequently reported. In this case of neonatal brucellosis, Brucella abortus was isolated by blood culture from both the mother and the neonate. Serology was positive only in the mother.

  9. Provider Perspectives Regarding Resuscitation Decisions for Neonates and Other Vulnerable Patients.

    PubMed

    Dupont-Thibodeau, Amélie; Hindié, Jade; Bourque, Claude Julie; Janvier, Annie

    2017-09-01

    To use structured surveys to assess the perspectives of pediatric residents and neonatal nurses on resuscitation decisions for vulnerable patients, including neonates. Pediatric providers were surveyed using scenarios for 6 critically ill patients of different ages with outcomes explicitly described. Providers were asked (1) whether resuscitation was in each patient's best interest; (2) whether they would accept families' wishes for comfort care (no resuscitation); and (3) to rank patients in order of priority for resuscitation. In a structured interview, each participant explained how they evaluated patient interests and when applicable, why their answers differed for neonates. Interviews were audiotaped; transcripts were analyzed using thematic analysis and mixed methods. Eighty pediatric residents and neonatal nurses participated (response rate 74%). When making life and death decisions, participants considered (1) patient characteristics (96%), (2) personal experience/biases (85%), (3) family's wishes and desires (81%), (4) disease characteristics (74%), and (5) societal perspectives (36%). These factors were not in favor of sick neonates: of the participants, 85% reported having negative biases toward neonates and 60% did not read, misinterpreted, and/or distrusted neonatal outcome statistics. Additional factors used to justify comfort care for neonates included limited personhood and lack of relationships/attachment (73%); prioritization of family's best interest, and social acceptability of death (36%). When these preconceptions were discussed, 70% of respondents reported they would change their answers in favor of neonates. Resuscitation decisions for neonates are based on many factors, such as considerations of personhood and family's interests (that are not traditional indicators of benefit), which may explain why decision making is different for the neonatal population. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The neonatal tear film.

    PubMed

    Lawrenson, John G; Murphy, Paul J; Esmaeelpour, Marieh

    2003-12-01

    The importance of the tear film for the integrity of the ocular surface is well established. Full-term neonates produce tears normally, but low spontaneous blink rates during early life raises important questions regarding tear dynamics and stability. Although an afferent neural pathway that could potentially detect tear break-up is in place at birth, there is indirect evidence that the neonatal tear film is adapted to resist evaporation-mediated tear thinning. This adaptation presumably prevents drying of the ocular surface during long inter-blink periods. However, low rates of tear turnover may have important implications for the defence of the eye against potential pathogens.

  11. Review of the mite subfamily Arctoseiinae Evans with a key to its genera and description of a new genus and species from Siberia (Parasitiformes, Mesostigmata, Ascidae)

    PubMed Central

    Lindquist, Evert E.; Makarova, Olga L.

    2012-01-01

    Abstract We redefine the subfamily Arctoseiinae of the family Ascidae, and describe a new genus, Maxinia gen. n., based on a new species, Maxinia arctomontana sp. n., whose adults display a combination of attri-butes uniquely different from other genera of the subfamily. The geographical range of Maxinia arctomontana is limited by arctic and mountain landscapes of Siberia. This description provides furtherdata on the arctic distribution and morphological diversity of the subfamily Arctoseiinae, which is unusually well represented in that region (26–83% in local gamasid mite faunas). Conceptual problems with the genus Iphidonopsis Gwiazdowicz, 2004 are reviewed, and a new combination, Iphidonopsis magnanalis (Ma & Yin, 1999) comb. n., is presented for Iphidozercon magnanalis Ma & Yin, 1999 from China. The genus Diseius Lindquist & Evans, 1965 is provisionally moved from the family Ascidae to the Digamasellidae. A new key to the genera of Arctoseiinae is presented. PMID:23226957

  12. Early neonatal mortality in India, 1990-2006.

    PubMed

    Kumar, Chandan; Singh, Prashant Kumar; Rai, Rajesh Kumar; Singh, Lucky

    2013-02-01

    The increased reach of health programs in India during the past few decades has contributed to a decline in postnatal mortality including infant and child mortality; however, reduction in neonatal mortality remained negligible. About seven out of ten neonatal deaths take place within a week after birth. The progress in reduction as well as dimension along which early neonatal mortality is patterned in India remains unclear. We examine the trend in early neonatal mortality and its possible demographic and socioeconomic predictors using nationally representative data. Data from the three cross-sectional rounds of the National Family Health Survey of India from 1992 to 1993, 1998 to 1999 and 2005 to 2006 were analyzed. Early neonatal mortality rate was estimated for selected demographic and socioeconomic population groups and for major states in India using information on births and deaths during the 3 years preceding the respective surveys. Using the multivariate logistic regression model, we assessed proximate determinants of early neonatal deaths during 1990-2006. Sex of the child, child's birth size, birth order and interval, type of child's birth, mother's age at child's birth, mother's educational status, religion, household economic status and region of residence emerged as significant predictors of early neonatal deaths. The adjusted multivariate analysis indicates that majority of the socio-demographic predictors reveal a negligible decline in the probability of early neonatal deaths during 1990-2006. Moreover, based on comprehensive reviews of scientific literature on newborn's survival we document some of the recommended ways to prevent early neonatal mortality in India.

  13. THE DEVELOPMENTAL TOXICITY OF BROMOCHLOROACETONITRILE IN PREGNANT LONG-EVANS RATS

    EPA Science Inventory

    Bromochloroacetonitrile (BCAN) is a by-product of the chlorine disinfection of water containing natural organic material. Adverse effects of BCAN in an in vivo teratology screen (i.e. neonatal survival assay) gave reason for further investigation into the developmental toxicity o...

  14. THE DEVELOPMENTAL TOXICITY OF BROMOCHLOROACETONITRILE IN PREGNANT LONG-EVANS RATS

    EPA Science Inventory

    Bromochloroacetonitrile (BCAN) is a by-product of the chlorine disinfection of water containing natural organic material. Adverse effects of BCAN in an in vivo teratology screen (i.e. neonatal survival assay) gave reason for further investigation into the developmental toxicity o...

  15. Neonatal Marfan syndrome: a case report.

    PubMed

    Ng, D K; Chau, K W; Black, C; Thomas, T M; Mak, K L; Boxer, M

    1999-06-01

    A case of neonatal Marfan syndrome is presented. The patient was noted to have cardiomegaly and tricuspid regurgitation on antenatal ultrasound scan. She was born with long, slender fingers and toes, an aged appearance and non-paralytic hypotonia. Echocardiogram revealed a dilated right atrium, right ventricle, dysplastic tricuspid valve and severe tricuspid regurgitation. She subsequently died of severe heart failure. Post-mortem examination showed the pathological features of lobar emphysema and cystic medial necrosis of the aorta. These features supported the diagnosis of neonatal Marfan syndrome. Nucleotide sequencing showed substitution of G by A at codon 1032 in exon 25 located in the long arm of chromosome 15. This resulted in the substitution of a cysteine by a tyrosine. A de novo mutation is suggested by the absence of affected family members.

  16. Scrotal Swelling in the Neonate

    PubMed Central

    Basta, Amaya M.; Courtier, Jesse; Phelps, Andrew; Copp, Hillary L.; MacKenzie, John D.

    2016-01-01

    Discovery of scrotal swelling in a neonate can be a source of anxiety for parents, clinicians, and sonologists alike. This pictorial essay provides a focused review of commonly encountered scrotal masses and mimics specific to the neonatal setting. Although malignancy is a concern, it is very uncommon, as most neonatal scrotal masses are benign. Key discriminating features and management options are highlighted to improve the radiologist’s ability to diagnose neonatal scrotal conditions and guide treatment decisions. Neonatal scrotal processes ranging from common to uncommon will be discussed. PMID:25715370

  17. Neonatal Sepsis and Neutrophil Insufficiencies

    PubMed Central

    Melvan, John Nicholas; Bagby, Gregory J.; Welsh, David A.; Nelson, Steve; Zhang, Ping

    2011-01-01

    Sepsis has continuously been a leading cause of neonatal morbidity and mortality despite current advances in chemotherapy and patient intensive care facilities. Neonates are at high risk for developing bacterial infections due to quantitative and qualitative insufficiencies of innate immunity, particularly granulocyte lineage development and response to infection. Although antibiotics remain the mainstay of treatment, adjuvant therapies enhancing immune function have shown promise in treating sepsis in neonates. This chapter reviews current strategies for the clinical management of neonatal sepsis and analyzes mechanisms underlying insufficiencies of neutrophil defense in neonates with emphasis on new directions for adjuvant therapy development. PMID:20521927

  18. Correlation of injury severity and tissue Evans blue content, lipid peroxidation and clinical evaluation in acute spinal cord injury in rats.

    PubMed

    Kaptanoglu, Erkan; Okutan, Ozerk; Akbiyik, Filiz; Solaroglu, Ihsan; Kilinc, Asuman; Beskonakli, Etem

    2004-11-01

    To demonstrate the changes in microvascular permeability occurring in association with graded acute spinal cord injury and to determine whether tissue Evans blue content is a useful indicator of the severity of spinal cord injury. The study also aimed to test the ability of the Evans blue method to demonstrate secondary injury after spinal cord contusion. In step one of the study, spinal cord lipid peroxidation levels and spinal cord Evans blue content were evaluated at 2 h post-injury in five groups of rats: a control group, a laminectomy-only group and three trauma groups (10, 50, and 100 gcm). In step two, these rats were used for Evans blue assessment following clinical examination at 24 h post-injury. The laminectomy-only group showed no difference from the control group with regard to spinal cord lipid peroxidation levels, tissue Evans blue content, and clinical findings. Increase in spinal cord tissue Evans blue content and lipid peroxidation was correlated with increasing intensity of trauma. There was a negative correlation between trauma intensity and clinical findings, and there was an increase in spinal cord tissue Evans blue content at 24 h compared with that at 2 h. Determination of spinal cord tissue Evans blue content is a reliable, rapid, simple and inexpensive method that can be used in experimental spinal cord injury to assess the severity of injury and to evaluate neuroprotection studies. The present study is the first to show that the Evans blue technique is a useful method to demonstrate secondary injury of spinal cord tissue and vasculature.

  19. Determination of body water compartments in neonatal foals by use of indicator dilution techniques and multifrequency bioelectrical impedance analysis.

    PubMed

    Fielding, C Langdon; Magdesian, K Gary; Edman, Judy E

    2011-10-01

    To determine values for total body water (TBW), extracellular fluid volume (ECFV), intracellular fluid volume (ICFV), and plasma volume (PV) in healthy neonatal (< 24 hours old) foals and to create a multifrequency bioelectrical impedance analysis (MF-BIA) model for use in neonatal foals. 7 healthy neonatal foals. Deuterium oxide (0.4 g/kg, IV), sodium bromide (30 mg/kg, IV), and Evans blue dye (1 mg/kg, IV) were administered to each foal. Plasma samples were obtained following an equilibration period, and the TBW, ECFV, ICFV, and PV were calculated for each foal. An MF-BIA model was created by use of morphometric measurements from each foal. Mean ± SD values were obtained for TBW (0.744 ± 0.024 L/kg), ICFV (0.381 ± 0.018 L/kg), ECFV (0.363 ± 0.014 L/kg), and PV (0.096 ± 0.015 L/kg). The 95% limits of agreement between the MF-BIA and indicator dilution techniques were within ± 2 L for TBW and ECFV. Fluid volumes in neonatal foals were found to be substantially larger than fluid volumes in adult horses. Multifrequency bioelectrical impedance analysis may be a useful technique for predicting TBW, ICFV, and ECFV in neonatal foals.

  20. Neonatal manifestations of inherited bone marrow failure syndromes

    PubMed Central

    Khincha, Payal P.; Savage, Sharon A.

    2015-01-01

    SUMMARY The inherited bone marrow failure syndromes (IBMFS) are a rare yet clinically important cause of neonatal hematological and non-hematological manifestations. Many of these syndromes, such as Fanconi anemia, dyskeratosis congenita and Diamond–Blackfan anemia, confer risks of multiple medical complications later in life, including an increased risk of cancer. Some IBMFS may present with cytopenias in the neonatal period whereas others may present only with congenital physical abnormalities and progress to pancytopenia later in life. A thorough family history and detailed physical examination are integral to the work-up of any neonate in whom there is a high index of suspicion for an IBMFS. Correct detection and diagnosis of these disorders is important for appropriate long-term medical surveillance and counseling not only for the patient but also for appropriate genetic counselling of their families regarding recurrence risks in future children and generations. PMID:26724991

  1. Neonatal manifestations of inherited bone marrow failure syndromes.

    PubMed

    Khincha, Payal P; Savage, Sharon A

    2016-02-01

    The inherited bone marrow failure syndromes (IBMFS) are a rare yet clinically important cause of neonatal hematological and non-hematological manifestations. Many of these syndromes, such as Fanconi anemia, dyskeratosis congenita and Diamond-Blackfan anemia, confer risks of multiple medical complications later in life, including an increased risk of cancer. Some IBMFS may present with cytopenias in the neonatal period whereas others may present only with congenital physical abnormalities and progress to pancytopenia later in life. A thorough family history and detailed physical examination are integral to the work-up of any neonate in whom there is a high index of suspicion for an IBMFS. Correct detection and diagnosis of these disorders is important for appropriate long-term medical surveillance and counseling not only for the patient but also for appropriate genetic counselling of their families regarding recurrence risks in future children and generations.

  2. [Recommendations in neonatal resuscitation].

    PubMed

    2004-01-01

    The recommendations for neonatal resuscitation are not always based on sufficient scientific evidence and thus expert consensus based on current research, knowledge, and experience are useful for formulating practical protocols that are easy to follow. The latest recommendations, in 2000, modified previously published recommendations and are included in the present text.

  3. Evans functions and bifurcations of nonlinear waves of some nonlinear reaction diffusion equations

    NASA Astrophysics Data System (ADS)

    Zhang, Linghai

    2017-10-01

    The main purposes of this paper are to accomplish the existence, stability, instability and bifurcation of the nonlinear waves of the nonlinear system of reaction diffusion equations ut =uxx + α [ βH (u - θ) - u ] - w, wt = ε (u - γw) and to establish the existence, stability, instability and bifurcation of the nonlinear waves of the nonlinear scalar reaction diffusion equation ut =uxx + α [ βH (u - θ) - u ], under different conditions on the model constants. To establish the bifurcation for the system, we will study the existence and instability of a standing pulse solution if 0 < 2 (1 + αγ) θ < αβγ; the existence and stability of two standing wave fronts if 2 (1 + αγ) θ = αβγ and γ2 ε > 1; the existence and instability of two standing wave fronts if 2 (1 + αγ) θ = αβγ and 0 <γ2 ε < 1; the existence and instability of an upside down standing pulse solution if 0 < (1 + αγ) θ < αβγ < 2 (1 + αγ) θ. To establish the bifurcation for the scalar equation, we will study the existence and stability of a traveling wave front as well as the existence and instability of a standing pulse solution if 0 < 2 θ < β; the existence and stability of two standing wave fronts if 2 θ = β; the existence and stability of a traveling wave front as well as the existence and instability of an upside down standing pulse solution if 0 < θ < β < 2 θ. By the way, we will also study the existence and stability of a traveling wave back of the nonlinear scalar reaction diffusion equation ut =uxx + α [ βH (u - θ) - u ] -w0, where w0 = α (β - 2 θ) > 0 is a positive constant, if 0 < 2 θ < β. To achieve the main goals, we will make complete use of the special structures of the model equations and we will construct Evans functions and apply them to study the eigenvalues and eigenfunctions of several eigenvalue problems associated with several linear differential operators. It turns out that a complex number λ0 is an eigenvalue of the linear

  4. [Neonatal medicine, past and present].

    PubMed

    Salle, Bernard L; Vert, Paul

    2013-06-01

    This review deals with early neonatal medicine and its rapid development as a medical specialty, starting with the birth of neonatology in the early 19th century. Shaffer first used the term neonatology in 1963 to cover neonatal disorders and their treatment. Between the early 19th century and the 1950s, neonatal care was ensured by obstetricians, whose main goal was to reduce neonatal mortality. After the second world war, and especially the 1960s, the development of neonatal physiology and pathophysiology provided insights into neonatal diseases and their treatment, including respiratory distress, jaundice, malnutrition, and prevention of respiratory distress and brain complications, etc. Currently, neonatal mortality, regardless of birth weight, is below 2/1000, and the survival rate of premature infants, regardless of gestational age and birth weight, exceeds 85%. This represents a resounding success, despite the associated costs, ethical issues, and inevitable morbidity.

  5. [Recommendations for neonatal transport].

    PubMed

    Moreno Hernando, J; Thió Lluch, M; Salguero García, E; Rite Gracia, S; Fernández Lorenzo, J R; Echaniz Urcelay, I; Botet Mussons, F; Herranz Carrillo, G; Sánchez Luna, M

    2013-08-01

    During pregnancy, it is not always possible to identify maternal or foetal risk factors. Infants requiring specialised medical care are not always born in centres providing intensive care and will need to be transferred to a referral centre where intensive care can be provided. Therefore Neonatal Transport needs to be considered as part of the organisation of perinatal health care. The aim of Neonatal Transport is to transfer a newborn infant requiring intensive care to a centre where specialised resources and experience can be provided for the appropriate assessment and continuing treatment of a sick newborn infant. Intrauterine transfer is the ideal mode of transport when the birth of an infant with risk factors is diagnosed. Unfortunately, not all problems can be detected in advance with enough time to safely transfer a pregnant woman. Around 30- 50% of risk factors will be diagnosed during labour or soon after birth. Therefore, it is important to have the knowledge and resources to resuscitate and stabilise a newborn infant, as well as a specialised neonatal transport system. With this specialised transport it is possible to transfer newly born infants with the same level of care that they would receive if they had been born in a referral hospital, without increasing their risks or affecting the wellbeing of the newborn. The Standards Committee of the Spanish Society of Neonatology reviewed and updated recommendations for intrauterine transport and indications for neonatal transfer. They also reviewed organisational and logistic factors involved with performing neonatal transport. The Committee review included the type of personnel who should be involved; communication between referral and receiving hospitals; documentation; mode of transport; equipment to stabilise newly born infants; management during transfer, and admission at the referral hospital.

  6. The clinical, operational, and financial worlds of neonatal palliative care: A focused ethnography.

    PubMed

    Williams-Reade, Jackie; Lamson, Angela L; Knight, Sharon M; White, Mark B; Ballard, Sharon M; Desai, Priti P

    2015-04-01

    Due to multiple issues, integrated interdisciplinary palliative care teams in a neonatal intensive care unit (NICU) may be difficult to access, sometimes fail to be implemented, or provide inconsistent or poorly coordinated care. When implementing an effective institution-specific neonatal palliative care program, it is critical to include stakeholders from the clinical, operational, and financial worlds of healthcare. In this study, researchers sought to gain a multidisciplinary perspective into issues that may impact the implementation of a formal neonatal palliative care program at a tertiary regional academic medical center. In this focused ethnography, the primary researcher conducted semistructured interviews that explored the perspectives of healthcare administrators, finance officers, and clinicians about neonatal palliative care. The perspectives of 39 study participants informed the identification of institutional, financial, and clinical issues that impact the implementation of neonatal palliative care services at the medical center and the planning process for a formal palliative care program on behalf of neonates and their families. Healthcare professionals described experiences that influenced their views on neonatal palliative care. Key themes included: (a) uniqueness of neonatal palliative care, (b) communication and conflict among providers, (c) policy and protocol discrepancies, and (d) lack of administrative support. The present study highlighted several areas that are challenging in the provision of neonatal palliative care. Our findings underscored the importance of recognizing and procuring resources needed simultaneously from the clinical, operational, and financial worlds in order to implement and sustain a successful neonatal palliative care program.

  7. Maternal, neonatal and community factors influencing neonatal mortality in Brazil.

    PubMed

    Machado, Carla Jorge; Hill, Kenneth

    2005-03-01

    Child mortality (the mortality of children less than five years old) declined considerably in the developing world in the 1990s, but infant mortality declined less. The reductions in neonatal mortality were not impressive and, as a consequence, there is an increasing percentage of infant deaths in the neonatal period. Any further reduction in child mortality, therefore, requires an understanding of the determinants of neonatal mortality. 209,628 birth and 2581 neonatal death records for the 1998 birth cohort from the city of São Paulo, Brazil, were probabilistically matched. Data were from SINASC and SIM, Information Systems on Live Births and Deaths of Brazil. Logistic regression was used to find the association between neonatal mortality and the following risk factors: birth weight, gestational age, Apgar scores at 1 and 5 minutes, delivery mode, plurality, sex, maternal education, maternal age, number of prior losses, prenatal care, race, parity and community development. Infants of older mothers were less likely to die in the neonatal period. Caesarean delivery was not found to be associated with neonatal mortality. Low birth weight, pre-term birth and low Apgar scores were associated with neonatal death. Having a mother who lives in the highest developed community decreased the odds of neonatal death, suggesting that factors not measured in this study are behind such association. This result may also indicate that other factors over and above biological and more proximate factors could affect neonatal death.

  8. Determinants of neonatal mortality in rural Northern Ethiopia: A population based nested case control study.

    PubMed

    Yirgu, Robel; Molla, Mitike; Sibley, Lynn

    2017-01-01

    In low income and middle income countries, neonatal mortality remains high despite the gradual reduction in under five mortality. Newborn death contributes for about 38% of all under five deaths. This study has identified the magnitude and independent predictors of neonatal mortality in rural Ethiopia. This population based nested case control study was conducted in rural West Gojam zone, Northern Ethiopia, among a cohort of pregnant women who gave birth between March 2011 and Feb 2012. The cohort was established by Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) project in 2010 by recruiting mothers in their third trimester, as identified by trained community volunteers. Once identified, women stayed in the cohort throughout their pregnancy period receiving Community Maternal and Newborn Health (CMNH) training by health extension workers and community volunteers till the end of the first 48 hours postpartum. Cases were 75 mothers who lost their newborns to neonatal death and controls were 150 randomly selected mothers with neonates who survived the neonatal period. Data to identify cause of death were collected using the WHO standard verbal autopsy questionnaire after the culturally appropriate 40 days of bereavement period. Binomial logistic regression model was used to identify independent contributors to neonatal mortality. The neonatal mortality rate was AOR(95%CI) = 18.6 (14.8, 23.2) per 1000 live births. Neonatal mortality declined with an increase in family size, neonates who were born among a family of more than two had lesser odds of death in the neonatal period than those who were born in a family of two AOR (95% CI) = 0.13 (0.02, 0.71). Mothers who gave birth to 2-4 AOR(95%CI) = 0.15 (0.05, 0.48) and 5+ children AOR(95%CI) = 0.08 (0.02, 0.26) had lesser odds of losing their newborns to neonatal mortality. Previous history of losing a newborn to neonatal death also increased the odds of neonatal mortality during the last birth AOR (95%CI

  9. Challenging Expertise: Paul Feyerabend vs. Harry Collins & Robert Evans on democracy, public participation and scientific authority: Paul Feyerabend vs. Harry Collins & Robert Evans on scientific authority and public participation.

    PubMed

    Sorgner, Helene

    2016-06-01

    This paper compares Feyerabend's arguments in Science in a Free Society to the controversial theory of expertise proposed by Harry Collins and Robert Evans as a Third Wave of Science Studies. Is the legitimacy of democratic decisions threatened by the unquestioned authority of scientific advice? Or does, on the contrary, science need protection from too much democratic participation in technical decisions? Where Feyerabend's political relativism envisions democratic society as inherently pluralist and demands equal contribution of all traditions and worldviews to public decision-making, Collins and Evans hold a conception of elective modernism, defending the reality and value of technical expertise and arguing that science deserves a privileged status in modern democracies, because scientific values are also democratic values. I will argue that Feyerabend's political relativism provides a valuable framework for the evaluation of Collins' and Evans' theory of expertise. By constructing a dialog between Feyerabend and this more recent approach in Science and Technology Studies, the aim of this article is not only to show where the two positions differ and in what way they might be reconciled, but also how Feyerabend's philosophy provides substantial input to contemporary debate. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. [Analysis of NIC interventions in a neonatal intensive care unit].

    PubMed

    Fernández, Daniel; Rodríguez, Magdalena; Rodríguez, Dolores; Gómez, Dolores; Estrella, Pilar; Liz, Mercedes

    2013-01-01

    The aim of the study was to describe and analyze the nursing interventions NIC developed in the clinical practice by specialized nurses in a Neonatal Intensive Care Unit (NICU). Descriptive study in the Neonatal Intensive Care Unit of University Complex Hospital of León. The study population included all the neonates admitted in the Neonatal Intensive Care Unit from 1 march to 30 november of 2011. Database was created with the statistical program Epi Info where NIC interventions were collected between the selected by the panel of experts. We collected a sum of 283 records of 44 neonates admitted with an average weight of 1705.5 gr and 14.3 days of age. Nurses have performed a total of 8861 NIC interventions. The highest percentage of interventions (47,1%) belong to the complex physiological domain, followed by the basic physiological (17,7%). We found 40,1%; 30,6% and 29,1% interventions in the early, late and night shifts. The highest percentage of interventions belong to the complex physiological domain although we can conclude that in the nursing clinical practice the solution of problems not only depend of interventions in that area but other areas such as family key intervention in the neonatal care. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  11. Decolourization of Diazo Evans Blue by Two Strains of Pseudomonas fluorescens Isolated from Different Wastewater Treatment Plants.

    PubMed

    Zabłocka-Godlewska, Ewa; Przystaś, Wioletta; Grabińska-Sota, Elżbieta

    2012-09-01

    The use of azo dyes is popular in different branches of industry. Discharge of colourants to surface water cause harmful environmental effects. The aim of the present study was evaluation of effectiveness of diazo Evans blue decolourization by two Pseudomonas strains and estimation of process byproducts toxicity. In static conditions, both tested strains removed more than 85 % of dye after 48 h and completely decolorized samples after 120 h. Agitation had negative impact on Evans blue removal (less than 70 % of dye removed after 120 h). Ecotoxicological effects were different for both studied strains beside comparable decolourization effectiveness. Increase of zootoxicity was noticed for strain Sz6 and decrease from IV to III class was noticed for strain SDz3. Optimization of process conditions for the most promising strain SDz3 should be deeply examined.

  12. Evans Blue is an inhibitor of nuclear factor-kappa B (NF-kappaB)-DNA binding.

    PubMed

    Sharma, Rakesh K; Otsuka, Masami; Pande, Vineet; Inoue, Jun-ichiro; João Ramos, Maria

    2004-12-20

    Nuclear factor-kappa B (NF-kappaB) is an important transcription factor, involved in many immune and inflammatory responses. It is critical in HIV gene expression as it has kappa B binding sites in the HIV-1 long-terminal repeat. Hence, targeting NF-kappaB to prevent its DNA binding holds a significant therapeutic potential. In this context, we report Evans Blue as a novel inhibitor of NF-kappaB-DNA binding. Evans Blue was found to be inhibiting DNA binding of NF-kappaB at a low concentration of 100 microM. Further, molecular modeling studies using docking and generation of electrostatic potential maps predicted a possible binding mode of EB to the DNA binding region of NF-kappaB, consistent with the experimental activity.

  13. Immunogenicity of Danish-SSI 1331 BCG vaccine in the UK: comparison with Glaxo-Evans 1077 BCG vaccine.

    PubMed

    Gorak-Stolinska, Patricia; Weir, Rosemary E; Floyd, Sian; Lalor, Maeve K; Stenson, Sally; Branson, Keith; Blitz, Rose; Luke, Sarah; Nazareth, Bernadette; Ben-Smith, Anne; Fine, Paul E M; Dockrell, Hazel M

    2006-07-17

    The immunogenicity and reactogenicity, in British schoolchildren, of the newly introduced Danish-SSI 1331 BCG vaccine was compared with that of the previously used Glaxo-Evans 1077 BCG vaccine. Interferon-gamma (IFN-gamma) response to M. tuberculosis purified protein derivative (M.tb PPD) in a 6-day whole blood assay and delayed type hypersensitivity (DTH) to tuberculin PPD were determined before and 1 year after receiving BCG or no vaccination. Scar size was measured 1 year after vaccination. There was no evidence of a difference in immunogenicity (IFN-gamma and DTH conversion rates) but evidence of lower reactogenicity (scar size) with Danish-SSI 1331 compared to Glaxo-Evans 1077 vaccines.

  14. Analysis of Zebrafish Larvae Skeletal Muscle Integrity with Evans Blue Dye

    PubMed Central

    Davidson, Ann E.; Dowling, James

    2015-01-01

    The zebrafish model is an emerging system for the study of neuromuscular disorders. In the study of neuromuscular diseases, the integrity of the muscle membrane is a critical disease determinant. To date, numerous neuromuscular conditions display degenerating muscle fibers with abnormal membrane integrity; this is most commonly observed in muscular dystrophies. Evans Blue Dye (EBD) is a vital, cell permeable dye that is rapidly taken into degenerating, damaged, or apoptotic cells; in contrast, it is not taken up by cells with an intact membrane. EBD injection is commonly employed to ascertain muscle integrity in mouse models of neuromuscular diseases. However, such EBD experiments require muscle dissection and/or sectioning prior to analysis. In contrast, EBD uptake in zebrafish is visualized in live, intact preparations. Here, we demonstrate a simple and straightforward methodology for performing EBD injections and analysis in live zebrafish. In addition, we demonstrate a co-injection strategy to increase efficacy of EBD analysis. Overall, this video article provides an outline to perform EBD injection and characterization in zebrafish models of neuromuscular disease. PMID:26649573

  15. Working-Memory Training: Effects on Delay Discounting in Male Long Evans Rats

    PubMed Central

    Renda, C. Renee; Stein, Jeffrey S.; Madden, Gregory J.

    2014-01-01

    Delay discounting describes the devaluation of a reward as the delay to the receipt of the reward increases. Because steep delay discounting is robustly correlated with a number of behavioral problems (e.g., substance dependence, gambling) and some evidence suggests steep discounting precedes and predicts drug-taking in humans and rats, this study sought to experimentally reduce rats' delay discounting. Human stimulant-dependent participants given working-memory training reportedly decreased their rates of discounting relative to a sham-training group (Bickel, Yi, Landes, Hill, & Baxter, 2011). To evaluate the cross-species generality of this effect, 38 male Long-Evans rats, matched on pretraining delay-discounting rates, were randomly assigned to receive 140 sessions of working-memory training or sham training (which required no memory of the sample stimulus). Large between-group differences in working memory were observed after training; however, posttraining delay-discounting rates were undifferentiated across groups. Potential explanations for these findings are discussed. PMID:25418508

  16. The effects of chronic photoperiod shifting on the physiology of female Long-Evans rats.

    PubMed

    Deibel, Scott H; Hong, Nancy S; Himmler, Stephanie M; McDonald, Robert J

    2014-04-01

    As the prevalence of shift work is increasing, it is important to elucidate the impact that shift work has on health. Because of the alternating work schedules present in rotating shift work and working at night, shift workers are in a chronic state of circadian disruption. Animal models of circadian disruption are useful because they offer more experimental control than the largely correlational human shift work studies. The effects of chronic circadian disruption on food preference, glucose tolerance, corticosterone secretion, and performance in a stress-inducing task were investigated in female Long-Evans rats. A 64-day photoperiod shifting paradigm was used to induce circadian disruption. Surprisingly, neither the photoperiod shifted animals, nor the control animals demonstrated a preference for either an unhealthy or healthy diet. Nor was there a difference between the groups in weight gained during photoperiod shifting. However, the photoperiod shifted rats gained significantly more weight than control animals, without eating more food during discriminative fear conditioning to context (DFCTC). Surprisingly, chronic photoperiod shifting appeared to facilitate retention in the DFCTC task. The photoperiod shifted animals also had increased serum glucose values during fasting and after a glucose challenge test. The photoperiod shifted animals only had elevated corticosterone during the final two phases of photoperiod shifting. This study demonstrates that chronic photoperiod shifting elicits weight gain when exposed to a stressful event and impairs glucose tolerance in the same individual.

  17. Structural and functional alterations of spinal cord axons in adult Long Evans Shaker (LES) dysmyelinated rats.

    PubMed

    Eftekharpour, Eftekhar; Karimi-Abdolrezaee, Soheila; Sinha, Kusum; Velumian, Alexander A; Kwiecien, Jacek M; Fehlings, Michael G

    2005-06-01

    Abnormal formation or loss of myelin is a distinguishing feature of many neurological disorders and contributes to the pathobiology of neurotrauma. In this study we characterize the functional and molecular changes in CNS white matter in Long Evans Shaker (LES) rats. These rats have a spontaneous mutation of the gene encoding myelin basic protein which results in severe dysmyelination of the central nervous system (CNS), providing a unique model for demyelinating/dysmyelinating disorders. To date, the functional and molecular changes in CNS white matter in this model are not well understood. We have used in vivo somatosensory evoked potential (SSEP), in vitro compound action potential (CAP) recording in isolated dorsal columns, confocal immunohistochemistry, Western blotting and real-time PCR to examine the electrophysiological, molecular and cellular changes in spinal cord white matter in LES rats. We observed that dysmyelination is associated with dispersed labeling of Kv1.1 and Kv1.2 K+ channel subunits, as well as Caspr, a protein normally confined to paranodes, along the LES rat spinal cord axons. Abnormal electrophysiological properties including attenuation of CAP amplitude and conduction velocity, high frequency conduction failure and enhanced sensitivity to K+ channel blockers 4-aminopyridine and dendrotoxin-I were observed in spinal cord axons from LES rats. Our results in LES rats clarify some of the key molecular, cellular and functional consequences of dysmyelination and myelin-axon interactions. Further understanding of these issues in this model could provide critical insights for neurological disorders characterized by demyelination.

  18. Obesity in the Otsuka Long Evans Tokushima Fatty Rat: Mechanisms and Discoveries

    PubMed Central

    Bi, Sheng; Moran, Timothy H.

    2016-01-01

    Understanding the neural systems underlying the controls of energy balance has been greatly advanced by identifying the deficits and underlying mechanisms in rodent obesity models. The current review focuses on the Otsuka Long Evans Tokushima Fatty (OLETF) rat obesity model. Since its recognition in the 1990s, significant progress has been made in identifying the causes and consequences of obesity in this model. Fundamental is a deficit in the cholecystokinin (CCK)-1 receptor gene resulting in the absence of CCK-1 receptors in both the gastrointestinal track and the brain. OLETF rats have a deficit in their ability to limit the size of meals and in contrast to CCK-1 receptor knockout mice, do not compensate for this increase in the size of their spontaneous meals, resulting in hyperphagia. Prior to becoming obese and in response to pair feeding, OLETF rats have increased expression of neuropeptide Y (NPY) in the compact region of the dorsomedial hypothalamus (DMH), and this overexpression contributes to their overall hyperphagia. Study of the OLETF rats has revealed important differences in the organization of the DMH in rats and mice and elucidated previously unappreciated roles for DMH NPY in energy balance and glucose homeostasis. PMID:27512691

  19. Tempol Protects Sleep-deprivation Induced Behavioral Deficits in Aggressive Male Long-Evans Rats

    PubMed Central

    Solanki, Naimesh; Atrooz, Fatin; Asghar, Saman; Salim, Samina

    2016-01-01

    Earlier, we reported that elevated anxiety-like behavior and high aggression in aged retired breeder Long-Evans (L-E) rats was associated with increased plasma corticosterone and elevated oxidative stress levels. In the present study, we examined how this aged aggressive and anxious rat strain responds to acute sleep deprivation (24 h) and whether their behaviors can be modulated via antioxidant tempol treatment. Four groups of L-E rats were utilized: naïve control (NC), tempol treated control (T+NC), sleep deprived (SD), tempol treated and sleep deprived (T+SD). Thus, two groups were treated with tempol (1mM in drinking water for 2 weeks) while the other two were not. Two groups were subjected to acute sleep deprivation (24 h) using the columns-in-water model while the other two were not. Sleep deprivation induced anxiety-like behavior, led to significant depression-like behavior and short-term memory impairment in SD rats. And, decision-making behavior also was compromised in SD rats. These behavioral and cognitive impairments were prevented with tempol treatment in T+SD rats. Tempol treatment also reduced SD-induced increase in corticosterone and oxidative stress levels in T+SD rats. These results suggest potential involvement of oxidative stress mechanisms in regulation of sleep deprivation induced behavioral and cognitive deficits in male aged-aggressive rats. PMID:26724222

  20. Evans Blue is not a suitable inhibitor of the epithelial sodium channel δ-subunit.

    PubMed

    Perniss, Alexander; Wolf, Annemarie; Wichmann, Lukas; Schönberger, Matthias; Althaus, Mike

    2015-10-23

    The Epithelial Sodium Channel (ENaC) is a heterotrimeric ion channel which can be either formed by assembly of its α-, β- and γ-subunits or, alternatively, its δ-, β- and γ-subunits. The physiological function of αβγ-ENaC is well established, but the function of δβγ-ENaC remains elusive. The azo-dye Evans Blue (EvB) has been routinely used to discriminate between the two channel isoforms by decreasing transmembrane currents and amiloride-sensitive current fractions of δβγ-ENaC expressing Xenopus oocytes. Even though these results could be reproduced, it was found by precipitation experiments and spectroscopic methods that the cationic amiloride and the anionic EvB directly interact in solution, forming a strong complex. Thereby a large amount of pharmacologically available amiloride is removed from physiological buffer solutions and the effective amiloride concentration is reduced. This interaction did not occur in the presence of albumin. In microelectrode recordings, EvB was able to abrogate the block of δβγ-ENaC by amiloride or its derivative benzamil. In sum, EvB reduces amiloride-sensitive ion current fractions in electrophysiological experiments. This is not a result of a specific inhibition of δβγ-ENaC but rather represents a pharmacological artefact. EvB should therefore not be used as an inhibitor of δ-ENaC. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Tempol protects sleep-deprivation induced behavioral deficits in aggressive male Long-Evans rats.

    PubMed

    Solanki, Naimesh; Atrooz, Fatin; Asghar, Saman; Salim, Samina

    2016-01-26

    Earlier, we reported that elevated anxiety-like behavior and high aggression in aged retired breeder Long-Evans (L-E) rats was associated with increased plasma corticosterone and elevated oxidative stress levels. In the present study, we examined how this aged aggressive and anxious rat strain responds to acute sleep deprivation (24h) and whether their behaviors can be modulated via antioxidant tempol treatment. Four groups of L-E rats were utilized: naïve control (NC), tempol treated control (T+NC), sleep deprived (SD), tempol treated and sleep deprived (T+SD). Thus, two groups were treated with tempol (1mM in drinking water for 2 weeks) while the other two were not. Two groups were subjected to acute sleep deprivation (24h) using the columns-in-water model while the other two were not. Sleep deprivation induced anxiety-like behavior, led to significant depression-like behavior and short-term memory impairment in SD rats. And, decision-making behavior also was compromised in SD rats. These behavioral and cognitive impairments were prevented with tempol treatment in T+SD rats. Tempol treatment also reduced SD-induced increase in corticosterone and oxidative stress levels in T+SD rats. These results suggest potential involvement of oxidative stress mechanisms in regulation of sleep deprivation induced behavioral and cognitive deficits in male aged-aggressive rats.

  2. Use of Evans blue dye to compare limb muscles in exercised young and old mdx mice.

    PubMed

    Wooddell, Christine I; Zhang, Guofeng; Griffin, Jacob B; Hegge, Julia O; Huss, Thierry; Wolff, Jon A

    2010-04-01

    Evans blue dye (EBD) is used to mark damaged and permeable muscle fibers in mouse models of muscular dystrophy and as an endpoint in therapeutic trials. We counted EBD-positive muscle fibers and extracted EBD from muscles sampled throughout the hindlimbs in young adult and old mdx mice to determine if the natural variability in morphology would allow measurement of a functional improvement in one limb compared to the contralateral limb. Following one bout of rotarod or treadmill exercise that greatly increased serum creatine kinase levels, the number of EBD(+) muscle fibers in 12-19-month-old mdx mice increased 3-fold, EBD in the muscles increased, and, importantly, contralateral pairs of muscles contained similar amounts of EBD. In contrast, the intra- and interlimb amounts of EBD in 2-7-month-old mdx mice were much too variable. A therapeutic effect can more readily be measured in old mdx mice. These results will be useful in the design of therapy protocols using the mdx mouse.

  3. Albumin-Binding Evans Blue Derivatives for Diagnostic Imaging and Production of Long-Acting Therapeutics.

    PubMed

    Jacobson, Orit; Kiesewetter, Dale O; Chen, Xiaoyuan

    2016-10-06

    One of the major design considerations for a drug is its pharmacokinetics: a drug with short blood half-life is less available at a target organ which in turn dictates treatment with either high or more frequent doses, and increases the likelihood of undesirable side effects. One method to improve drug pharmacokinetics is adding functional chemical groups to the drug molecule that can increase the half-life in the blood, hopefully, without significantly affecting its desired biological activity. Evans Blue (EB) dye reversibly binds to serum albumin with moderate affinity and has a long blood half-life. The binding of EB to albumin has been exploited to quantify protein leakage as an indicator of increased vascular permeability. Design of new chemical entities based on EB structure and coupling them to drugs, enables the usage of albumin as a reversible carrier in the blood and improves drug's half-life. This Topical Review summarizes the recent developments of various EB derivatives for molecular imaging and therapy applications.

  4. A New Modified Evans Blue Dye Test as Screening Test for Aspiration in Tracheostomized Patients.

    PubMed

    Fiorelli, Alfonso; Ferraro, Fausto; Nagar, Francesca; Fusco, Pierluigi; Mazzone, Salvatore; Costa, Giuseppe; Di Natale, Davide; Serra, Nicola; Santini, Mario

    2017-04-01

    The authors assessed the diagnostic accuracy of a new modified Evans blue dye test (MEBDT) as a screening test for aspiration in tracheostomized patients. Monocentric retrospective study performed between October 2013 and December 2015. Anesthesia and Intensive Care Unit, Second University of Naples. Among 62 eligible patients, 5 were excluded. The authors' study population included 57 patients. Patients underwent both fiberoptic endoscopic examination of the swallow (FEES) and MEBDT to evaluate swallow. The MEBDT results were compared with those of FEES and the diagnostic accuracy of MEBDT was calculated using the FEES as the gold standard. The authors found that both FEES and MEBDT were positive for aspiration in 40 patients (true-positive MEBDT); FEES and MEBDT were negative in 10 (true-negative MEBDT). On the other hand, FEES was positive with an MEBDT negative in 7 patients (false-negative MEBDT), and there were no FEES negative and MEBDT positive (false-positive MEBDT). MEBDT had a sensitivity, specificity, positive, and negative predicted value of 85%, 100%, 100%, and 58.82%, respectively. MEBDT could be a supplementary diagnostic test for aspiration. Patients with positive MEBDT should not undergo oral feeding, while patients with negative MEBDT should undergo FEES before starting oral feeding. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Analysis of Zebrafish Larvae Skeletal Muscle Integrity with Evans Blue Dye.

    PubMed

    Smith, Sarah J; Horstick, Eric J; Davidson, Ann E; Dowling, James

    2015-11-30

    The zebrafish model is an emerging system for the study of neuromuscular disorders. In the study of neuromuscular diseases, the integrity of the muscle membrane is a critical disease determinant. To date, numerous neuromuscular conditions display degenerating muscle fibers with abnormal membrane integrity; this is most commonly observed in muscular dystrophies. Evans Blue Dye (EBD) is a vital, cell permeable dye that is rapidly taken into degenerating, damaged, or apoptotic cells; in contrast, it is not taken up by cells with an intact membrane. EBD injection is commonly employed to ascertain muscle integrity in mouse models of neuromuscular diseases. However, such EBD experiments require muscle dissection and/or sectioning prior to analysis. In contrast, EBD uptake in zebrafish is visualized in live, intact preparations. Here, we demonstrate a simple and straightforward methodology for performing EBD injections and analysis in live zebrafish. In addition, we demonstrate a co-injection strategy to increase efficacy of EBD analysis. Overall, this video article provides an outline to perform EBD injection and characterization in zebrafish models of neuromuscular disease.

  6. Distinct patterns of cerebral extravasation by Evans blue and sodium fluorescein in rats.

    PubMed

    Yen, Lola Fenghuei; Wei, Vivi Chiali; Kuo, Eva Yuhua; Lai, Ted Weita

    2013-01-01

    The Evans blue dye (EBD; 961 Da) and the sodium fluorescein dye (NaF; 376 Da) are commonly used inert tracers in blood-brain barrier (BBB) research. They are both highly charged low molecular weight (LMW) tracers with similar lipophobic profiles. Nevertheless, the EBD binds to serum albumin (69,000 Da) to become a high molecular weight (HMW) protein tracer when injected into the circulation, whereas the NaF remains an unbound small molecule in the circulation. In this study, rats were injected with equal doses of either EBD or NaF to monitor their blood and tissue distribution. The EBD was largely confined to the circulation with little accumulation in the peripheral organ and even less accumulation in the central tissue, whereas the NaF distributed more evenly between the blood and the peripheral organ but was also largely excluded from the central tissue. Importantly, the EBD crossed the BBB most effectively at the prefrontal cortex and the cerebellum, and most poorly at the striatum. In marked contrast, the NaF was evenly distributed throughout the brain. Finally, the EBD exhibited this same peculiar tissue distribution profile when administered by either bolus injection or slow infusion. Our study suggests that different regions of the brain are equally permeable to LMW inert dyes like the NaF, but are markedly different in permeability to HMW proteins such as EBD-labelled serum albumin.

  7. Increase in Evans blue dye extravasation into the brain in the late developmental stage.

    PubMed

    Chen, Kuen-Bao; Kuo, Eva Yuhua; Poon, Kin-Shing; Cheng, Ka-Shun; Chang, Chia-Sheng; Liu, Yu-Cheng; Lai, Ted Weita

    2012-08-22

    The development of the blood-brain barrier (BBB) against permeability to inert tracers, such as Evans blue dye (EBD), occurs quite early on at embryonic stages (before E13-E15), and the BBB remains resistant to EBD between E15 and early adulthood (P20-P30). Here, we aimed to examine the changes in EBD permeability at a later stage in development, specifically comparing young rats (P20) with adult rats (P86). We found markedly higher EBD extravasation into the forebrains of adult rats compared with those of the young rats (P=0.0132; Student's t-test). In contrast, there was no difference in EBD extravasation to the liver, suggesting no change in vascular permeability in peripheral tissues. Furthermore, EBD extravasation into the cerebellum was less prominent than that into the forebrain, suggesting that the disruption of the BBB was brain-region specific. In conclusion, we found a specific increase in EBD extravasation in the mature forebrain, and the protocol that we used may be a good template for studying developmental disruption of the BBB.

  8. Cultivation-independent and -dependent characterization of Bacteria resident beneath John Evans Glacier.

    PubMed

    Cheng, Stephanie M; Foght, Julia M

    2007-02-01

    Viable microorganisms are present in subglacial waters and sediment-laden ice beneath John Evans glacier in the Canadian high Arctic. The Bacterial communities resident in three subglacial samples were examined by amplifying 16S rRNA genes extracted from community DNA and from axenic isolates. Restriction fragment length polymorphism analysis of 341 clones produced 153 operational taxonomic units (OTUS), of which 25 dominant OTUS were sequenced. A subglacial water sample yielded Betaproteobacteria (25% of clones, particularly Comamonadaceae), Bacteroidetes (23%, particularly Flavobacterium) and Actinobacteria (14%). A second water sample had 51%Betaproteobacteria, 5%Bacteroidetes and no Actinobacteria, and a sediment sample was dominated by Betaproteobacteria (15%) and Bacteroidetes (38%). A collection of 158 morphologically distinct isolates was obtained on R2A agar using three incubation conditions: fully aerobic at 20 degrees C or 4 degrees C, or microaerobic at 20 degrees C. A total of 52 isolate OTUs were defined, comprising Bacteroidetes (predominantly Flavobacterium isolated at 4 degrees C), Betaproteobacteria (particularly Comamonadaceae), plus Actinobacteria and Alpha- and Gammaproteobacteria not detected as clones. Otherwise, the clone library and isolate collection results were quite comparable and supported earlier molecular studies at this site. Although additional undescribed diversity likely exists in these samples, combining culture-based results with molecular analysis increased the observed bacterial diversity and confirmed previous observations at this glacier and others.

  9. Unmasking Evans syndrome: T-cell phenotype and apoptotic response reveal autoimmune lymphoproliferative syndrome (ALPS).

    PubMed

    Teachey, David T; Manno, Catherine S; Axsom, Kelly M; Andrews, Timothy; Choi, John K; Greenbaum, Barbara H; McMann, Joseph M; Sullivan, Kathleen E; Travis, Susan F; Grupp, Stephan A

    2005-03-15

    Autoimmune lymphoproliferative syndrome (ALPS) is a rare disorder of disrupted lymphocyte homeostasis. Clinical manifestations of ALPS vary but typically include autoimmune cytopenias, organomegaly, lymphadenopathy, and increased risk of malignancies. A similar spectrum of symptoms may be seen in some patients with Evans syndrome (ES), a hematologic disorder defined by autoimmune destruction of at least 2 hematologic cell types. We hypothesized that a subset of patients diagnosed with ES may have ALPS. We screened 12 children with ES by flow cytometric analysis for CD4-/CD8- (double negative) T cells (DNTs) and with the definitive test for ALPS, defective in vitro Fas-mediated apoptosis. Six of the patients had elevated DNTs, suggestive of ALPS and also had defective Fas-mediated apoptosis. The other 6 patients displayed normal T-cell apoptosis; 5 of whom had normal DNTs, and 1 had a borderline result. Thus, 7 (58%) of 12 patients with ES had elevated DNTs suggestive of ALPS, with functional confirmation in 6 of 7. This suggests that analysis of DNTs may be a sensitive first-line screening test, serving as a marker of patients who should undergo definitive testing for ALPS. Our data further suggest that a number of patients with ES may have ALPS, a novel finding with important therapeutic implications.

  10. Early-onset Evans syndrome, immunodeficiency, and premature immunosenescence associated with tripeptidyl-peptidase II deficiency

    PubMed Central

    Stepensky, Polina; Rensing-Ehl, Anne; Gather, Ruth; Revel-Vilk, Shoshana; Fischer, Ute; Nabhani, Schafiq; Beier, Fabian; Brümmendorf, Tim H.; Fuchs, Sebastian; Zenke, Simon; Firat, Elke; Pessach, Vered Molho; Borkhardt, Arndt; Rakhmanov, Mirzokhid; Keller, Bärbel; Warnatz, Klaus; Eibel, Hermann; Niedermann, Gabriele; Elpeleg, Orly

    2015-01-01

    Autoimmune cytopenia is a frequent manifestation of primary immunodeficiencies. Two siblings presented with Evans syndrome, viral infections, and progressive leukopenia. DNA available from one patient showed a homozygous frameshift mutation in tripeptidyl peptidase II (TPP2) abolishing protein expression. TPP2 is a serine exopeptidase involved in extralysosomal peptide degradation. Its deficiency in mice activates cell death programs and premature senescence. Similar to cells from naïve, uninfected TPP2-deficient mice, patient cells showed increased major histocompatibility complex I expression and most CD8+ T-cells had a senescent CCR7-CD127−CD28−CD57+ phenotype with poor proliferative responses and enhanced staurosporine-induced apoptosis. T-cells showed increased expression of the effector molecules perforin and interferon-γ with high expression of the transcription factor T-bet. Age-associated B-cells with a CD21− CD11c+ phenotype expressing T-bet were increased in humans and mice, combined with antinuclear antibodies. Moreover, markers of senescence were also present in human and murine TPP2-deficient fibroblasts. Telomere lengths were normal in patient fibroblasts and granulocytes, and low normal in lymphocytes, which were compatible with activation of stress-induced rather than replicative senescence programs. TPP2 deficiency is the first primary immunodeficiency linking premature immunosenescence to severe autoimmunity. Determination of senescent lymphocytes should be part of the diagnostic evaluation of children with refractory multilineage cytopenias. PMID:25414442

  11. Obesity in the Otsuka Long Evans Tokushima Fatty Rat: Mechanisms and Discoveries.

    PubMed

    Bi, Sheng; Moran, Timothy H

    2016-01-01

    Understanding the neural systems underlying the controls of energy balance has been greatly advanced by identifying the deficits and underlying mechanisms in rodent obesity models. The current review focuses on the Otsuka Long Evans Tokushima Fatty (OLETF) rat obesity model. Since its recognition in the 1990s, significant progress has been made in identifying the causes and consequences of obesity in this model. Fundamental is a deficit in the cholecystokinin (CCK)-1 receptor gene resulting in the absence of CCK-1 receptors in both the gastrointestinal track and the brain. OLETF rats have a deficit in their ability to limit the size of meals and in contrast to CCK-1 receptor knockout mice, do not compensate for this increase in the size of their spontaneous meals, resulting in hyperphagia. Prior to becoming obese and in response to pair feeding, OLETF rats have increased expression of neuropeptide Y (NPY) in the compact region of the dorsomedial hypothalamus (DMH), and this overexpression contributes to their overall hyperphagia. Study of the OLETF rats has revealed important differences in the organization of the DMH in rats and mice and elucidated previously unappreciated roles for DMH NPY in energy balance and glucose homeostasis.

  12. Transcranial direct current stimulation improves visual acuity in amblyopic Long-Evans rats.

    PubMed

    Castaño-Castaño, S; Garcia-Moll, A; Morales-Navas, M; Fernandez, E; Sanchez-Santed, F; Nieto-Escamez, F

    2017-02-15

    Transcranial direct current stimulation (tDCS) has proved to increase brain cortex plasticity and different models of brain damage. In this work, we have analyzed the effects of tDCS in an experimental model of amblyopia using Long-Evans rats. Animals were monocularly deprived between 12 and 75 postnatal days and visual cortex contralateral to the deprived eye was stimulated using anodal tDCS during 8days (20min/day). The effects of tDCS treatment on the visual function were evaluated by using the optomotor reflex of the animals as a measure of visual acuity. Results obtained indicate that monocular occlusion during the critical period lead to a reduction of visual acuity in monocular and binocular conditions. Stimulation with anodal tDCS produced a nearly full recovery in visual acuity of amblyopic animals. However, same stimulation protocol in healthy control animals produced a decrease of binocular visual acuity. These data indicate that tDCS can reverse the effects of monocular deprivation on visual acuity, although it is essential to use this technique in a controlled way due to the possible adverse effects on healthy individuals.

  13. Early-onset Evans syndrome, immunodeficiency, and premature immunosenescence associated with tripeptidyl-peptidase II deficiency.

    PubMed

    Stepensky, Polina; Rensing-Ehl, Anne; Gather, Ruth; Revel-Vilk, Shoshana; Fischer, Ute; Nabhani, Schafiq; Beier, Fabian; Brümmendorf, Tim H; Fuchs, Sebastian; Zenke, Simon; Firat, Elke; Pessach, Vered Molho; Borkhardt, Arndt; Rakhmanov, Mirzokhid; Keller, Bärbel; Warnatz, Klaus; Eibel, Hermann; Niedermann, Gabriele; Elpeleg, Orly; Ehl, Stephan

    2015-01-29

    Autoimmune cytopenia is a frequent manifestation of primary immunodeficiencies. Two siblings presented with Evans syndrome, viral infections, and progressive leukopenia. DNA available from one patient showed a homozygous frameshift mutation in tripeptidyl peptidase II (TPP2) abolishing protein expression. TPP2 is a serine exopeptidase involved in extralysosomal peptide degradation. Its deficiency in mice activates cell death programs and premature senescence. Similar to cells from naïve, uninfected TPP2-deficient mice, patient cells showed increased major histocompatibility complex I expression and most CD8(+) T-cells had a senescent CCR7-CD127(-)CD28(-)CD57(+) phenotype with poor proliferative responses and enhanced staurosporine-induced apoptosis. T-cells showed increased expression of the effector molecules perforin and interferon-γ with high expression of the transcription factor T-bet. Age-associated B-cells with a CD21(-) CD11c(+) phenotype expressing T-bet were increased in humans and mice, combined with antinuclear antibodies. Moreover, markers of senescence were also present in human and murine TPP2-deficient fibroblasts. Telomere lengths were normal in patient fibroblasts and granulocytes, and low normal in lymphocytes, which were compatible with activation of stress-induced rather than replicative senescence programs. TPP2 deficiency is the first primary immunodeficiency linking premature immunosenescence to severe autoimmunity. Determination of senescent lymphocytes should be part of the diagnostic evaluation of children with refractory multilineage cytopenias.

  14. Reframing violence against women as a human rights violation: Evan Stark's Coercive Control.

    PubMed

    Libal, Kathryn; Parekh, Serena

    2009-12-01

    Evan Stark claims that partner-perpetrated physical abuse and other forms of violence against women ought to be understood as a human rights violation. The authors engage Stark's rhetorically powerful political and analytical innovation by outlining one theoretical and one practical challenge to shifting the paradigm that researchers, advocates, and policy makers use to describe, explain, and remedy the harms of coercive control from misdemeanor assault to human rights violation. The theoretical challenge involves overcoming the public/ private dichotomy that underpins liberal conceptions of human rights.The practical challenge involves using the human rights framework in the United States, given public indifference to human rights rhetoric or law, reluctance of U.S. policy makers to submit to scrutiny or justice-oriented processes under international law on issues of human rights and especially war crimes, and the consequent U.S. legacy of refusal to participate meaningfully in the international human rights process. The authors conclude that employing a human rights framework holds potential in the United States, but the paradigm shift Stark advocates will not materialize without widespread mobilization of interest in and understanding of human rights among domestic violence advocates and the society in general.

  15. Comparison Evans Blue injection routes: Intravenous versus intraperitoneal, for measurement of blood-brain barrier in a mice hemorrhage model.

    PubMed

    Manaenko, Anatol; Chen, Hank; Kammer, Jerome; Zhang, John H; Tang, Jiping

    2011-02-15

    Intracerebral hemorrhage is one of the most devastating subtypes of stroke, leaving survivors with severe neurological deficits. Disruption of the blood brain barrier (BBB) following hemorrhage results in the development of vasogenic brain edema, a most life-threatening event after such events as intracerebral hemorrhage (ICH). The Evans Blue assay is a popular method for the quantification of BBB disruption. Although this method is in common use, there are several protocols of the assay in the literature which vary in the route of administration, as well as the circulation time of the stain. In this study, we compared the amounts of accumulated stain in brain tissue following intraperitoneal versus intravenous injection at 0.5, 3 and 24h of circulation time. 58 CD-1 mice were used. Animals were divided into ICH (N=42), sham groups (N=6) and naïve (N=10). ICH animals received stereotactic injection of collagenase type VII into the right basal ganglia. Sham animals received only needle trauma. Evans Blue stain was injected 24h after collagenase injection or needle trauma. The consistency of ICH produced was characterized by estimation of hematoma volume via hemoglobin assay and neurological evaluation. The produced hematoma and neurological deficits were well comparable between different experimental groups. There was no statistically significant difference in the results of the Evans Blue assay with regard to administration route. The amount of Evans Blue stain accumulated in the brains of mice after ICH produced by collagenase injection was independent of the stain administration route. © 2010 Elsevier B.V. All rights reserved.

  16. Acute and subchronic toxicity of inhaled toluene in male Long Evans rats: oxidative stress markers in brain

    EPA Pesticide Factsheets

    Research interested in oxidative stress markers following exposure to VOCsThis dataset is associated with the following publication:Kodavanti , P., J. Royland , D.A. Moore-Smith, J. Beas, J. Richards , T. Beasley , P. Evansky , and P.J. Bushnell. Acute and Subchronic Toxicity of Inhaled Toluene in Male Long-Evans Rats: Oxidative Stress Markers in Brain. NEUROTOXICOLOGY. Elsevier B.V., Amsterdam, NETHERLANDS, 51: 10-19, (2015).

  17. Plasma volume in acute hypoxia: comparison of a carbon monoxide rebreathing method and dye dilution with Evans' blue.

    PubMed

    Poulsen, T D; Klausen, T; Richalet, J P; Kanstrup, I L; Fogh-Andersen, N; Olsen, N V

    1998-04-01

    Exposure to acute hypoxia is associated with changes in body fluid homeostasis and plasma volume (PV). This study compared a dye dilution technique using Evans' blue (PV[Evans']) with a carbon monoxide (CO) rebreathing method (PV[CO]) for measurements of PV in ten normal subjects at sea level and again 24 h after rapid passive ascent to high altitude (4,350 m). Hypobaric hypoxia decreased arterial oxygen saturation to 79 (74-83)% (mean with 95% confidence intervals). The PV(Evans') remained unchanged from 3.49 (3.30-3.68) l at sea level to 3.46 (3.24-3.68) l at high altitude. In contrast PV(CO) decreased from 3.39 (3.17-3.61) l at sea level to 3.04 (2.75-3.33) l at high altitude (P < 0.05). Compared with sea level, this resulted in an increase of the mean bias between the two methods [from 0.11 (-0.05-0.27) l at sea level to 0.43 (0.26-0.60) l at high altitude] so that the ratio between PV(Evans') and PV(CO) increased from 1.04 (0.99-1.09) at sea level to 1.15 (1.06-1.24) at high altitude (P < 0.05). In conclusion, the two methods were not interchangeable as measures of hypoxia-induced changes in PV. The mechanism responsible for the bias remains unknown, but it is suggested that the results may reflect a redistribution of albumin caused by the combined effects in hypoxia of both an increased capillary permeability to albumin and a decrease in PV. As a result, the small perivascular compartment of albumin beyond the endothelium may increase without changes in the overall albumin distribution volume.

  18. Neonatal thyroid storm accompanied with severe anaemia.

    PubMed

    Cao, Lu-Ying; Wei, Hong; Wang, Zheng-Li

    2015-07-01

    Neonatal thyroid storm is rare; the diagnostic criteria and management of neonatal thyroid storm have not been well established. In this paper, we report a preterm infant diagnosed with neonatal hyperthyroidism secondary to maternal Graves' disease who was discharged after therapy. Unfortunately, he was rehospitalised for neonatal thyroid storm. We will discuss the diagnosis and general therapy of neonatal thyroid storm.

  19. The development of a neonatal communication intervention tool.

    PubMed

    Strasheim, Esedra; Kritzinger, Alta; Louw, Brenda

    2011-10-01

    Neonatal communication intervention is important in South Africa, which has an increased prevalence of infants born with risks for disabilities and where the majority of infants live in poverty. Local literature showed a dearth of information on the current service delivery and roles of speech-language therapists (SLTs) and audiologists in neonatal nurseries in the South African context. SLTs have the opportunity to provide the earliest intervention, provided that intervention is well-timed in the neonatal nursery context. The aim of the research was to compile a locally relevant neonatal communication intervention instrument/tool for use by SLTs in neonatal nurseries of public hospitals. The study entailed descriptive, exploratory research. During phase 1, a survey was received from 39 SLTs and 2 audiologists in six provinces. The data revealed that participants performed different roles in neonatal nurseries, which depended on the environment, tools, materials and instrumentation available to them. Many participants were inexperienced, but resourceful in their attempts to adapt tools/materials. Participants expressed needs for culturally appropriate and user-friendly instruments for parent guidance and staff/team training on the topic of developmental care. During phase 2, a tool for parent guidance titled Neonatal communication intervention programme for parents was compiled in English and isiZulu. The programme was piloted by three participants. Suggestions for enhancements of the programme were made, such as providing a glossary of terms, adapting the programme's language and terminology, and providing more illustrations. SLTs and audiologists must contribute to neonatal care of high-risk infants to facilitate development and to support families.

  20. Prediction of initiation and duration of breast-feeding for neonates admitted to the neonatal intensive care unit.

    PubMed

    Lessen, Rachelle; Crivelli-Kovach, Andrea

    2007-01-01

    Women who desire to breast-feed their sick newborns often encounter obstacles, including insufficient support and education as well as unsupportive hospital practices. The purpose of this study was to describe maternal, neonatal, and outside influences associated with the intention, initiation, and duration of breast-feeding for women whose newborns were admitted to the neonatal intensive care unit. One hundred mothers were interviewed. Most mothers (67%) intended to breast-feed exclusively and this was significantly related to maternal characteristics such as age, education, parity, smoking and marital status, pre-breast-feeding experience, and the influences of the neonate's father and prenatal education. Seventy-eight mothers initiated pumping. Initiation was significantly related to maternal education, smoking, parity, previous breast-feeding experience, the neonate's physician, the neonate's father, and postpartum breast-feeding education. Fifty-four mothers were followed up by telephone after discharge until weaning. Thirty percent were exclusively breast-feeding at 2 weeks after discharge, and 15% were breast-feeding at 1 year. Duration of breast-feeding was significantly associated with education, marital status, ethnicity, income, assistance from nurses and lactation consultants, and feeding method along with milk type and milk volume at discharge. Increased family support, timely breast-feeding information, and a supportive neonatal intensive care unit environment are needed for women to succeed in breast-feeding their hospitalized newborns.

  1. Neonatal septic arthritis.

    PubMed

    Dan, M

    1983-11-01

    To assess and correlate the microbiology of neonatal septic arthritis with the clinical presentation, we reviewed the records of nine infants with neonatal septic arthritis (NSA) diagnosed at Edmonton hospitals between 1964 and 1981, and evaluated 92 other cases reported in the English literature since 1960. Our analysis revealed that the microbiology of NSA seemed to be dependent on whether it was hospital or community acquired. In the hospital-acquired cases, staphylococci were the predominant isolates (62%), followed by Candida species (17%) and gram-negative enteric bacilli (15%). Community-acquired arthritis was caused most often by streptococci (52%), followed by staphylococci (26%) and gonococci (17%). Since 1970, the relative infrequency of staphylococcal (5%) in favor of streptococcal (75%) isolates in community-acquired NSA is even more pronounced.

  2. Neonatal compartment syndrome.

    PubMed

    Martin, B; Treharne, L

    2016-09-01

    A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necrotic tissue, he underwent split-thickness skin grafting of the resultant defects of his forearm, hand and digits. At the clinic follow-up appointment two months after the procedure, he was found to have developed severe flexion contractures despite regular outpatient hand therapy and splintage. He has had further reconstruction with contracture release, use of artificial dermal matrix, and K-wire fixation of the thumb and wrist. Despite this, the long term outcome is likely to be an arm with poor function. The key learning point from this case is that despite prompt transfer, diagnosis and appropriate surgical management, the outcome for neonatal compartment syndrome may still be poor.

  3. Neonatal hematologic disorders.

    PubMed

    Purves, Erica

    2005-01-01

    Neonatal hematology is a complex subspecialty of pediatric hematology, combining the unique aspects of the maternal/fetal relationship, the delicate balance of coagulation factors, and the distinctive physiologic conditions of the newborn period. The objective of this article is to briefly review specific hematologic disorders that commonly present in the newborn period. Alloimmune cytopenias, polycythemia, thrombosis and bleeding associated with vitamin K deficiency will be discussed through a focus on pathophysiology, signs and symptoms, current treatment strategies, and implications for nursing care.

  4. [Neonatal conventional ventilation guidelines].

    PubMed

    2001-09-01

    Respiratory pathology is a frequent problem in Neonatal Intensive Care Units; the last few years, our knowledge about its management has improved enormously. Conventional Ventilatory support is a high-specialized technique that maintains a correct alveolar gas exchange while the primary aetiology is to present some clinical guidelines for every professional working with newborns who have respiratory failure improves. The aim of this document is to present some clinical guidelines for every professional working with newborns who have respiratory pathology

  5. Bed bug outbreak in a neonatal unit.

    PubMed

    Bandyopadhyay, T; Kumar, A; Saili, A

    2015-10-01

    There has been a worldwide increase in bed bug infestations over the last 10-15 years. A major stigma is placed upon the institutions found to be infested. We report our experience with an outbreak of the tropical bed bug, Cimex hemipterus, in a neonatal unit. The outbreak not only affected the admitted newborns and mothers by causing a wide variety of rashes and inducing sleeplessness, but also impinged upon the health professionals and their families by producing similar symptomology. It is important for healthcare providers to be aware of, and for each healthcare facility to have, bed bug prevention and control policies.

  6. Compassion Fatigue, Burnout, and Neonatal Abstinence Syndrome.

    PubMed

    Sweigart, Erin

    2017-01-01

    NICU nurses have seen a dramatic increase in cases of neonatal abstinence syndrome (NAS). The care needs of infants with NAS are highly demanding and can lead to feelings of frustration and emotional exhaustion among NICU nurses. Although studies have examined the experiences of nurses caring for NAS patients, none have specifically addressed the risk for compassion fatigue and burnout. Nurses need practical strategies to reduce their risk for compassion fatigue and burnout when caring for these patients. Improved education and implementation of self-care measures can help nurses more effectively manage stress and positively impact care of these infants and their families.

  7. Intestinal ischemia in neonates and children.

    PubMed

    Jeican, Ionuţ Isaia; Ichim, Gabriela; Gheban, Dan

    2016-01-01

    The article reviews the intestinal ischemia theme on newborn and children. The intestinal ischemia may be either acute - intestinal infarction (by vascular obstruction or by reduced mesenteric blood flow besides the occlusive mechanism), either chronic. In neonates, acute intestinal ischemia may be caused by aortic thrombosis, volvulus or hypoplastic left heart syndrome. In children, acute intestinal ischemia may be caused by fibromuscular dysplasia, volvulus, abdominal compartment syndrome, Burkitt lymphoma, dermatomyositis (by vascular obstruction) or familial dysautonomia, Addison's disease, situs inversus abdominus (intraoperative), burns, chemotherapy administration (by nonocclusive mesenteric ischemia). Chronic intestinal ischemia is a rare condition in pediatrics and can be seen in abdominal aortic coarctation or hypoplasia, idiopathic infantile arterial calcinosis.

  8. Causes of neonatal brachial plexus palsy.

    PubMed

    Alfonso, Daniel T

    2011-01-01

    The causes of brachial plexus palsy in neonates should be classified according to their most salient associated feature. The causes of brachial plexus palsy are obstetrical brachial plexus palsy, familial congenital brachial plexus palsy, maternal uterine malformation, congenital varicella syndrome, osteomyelitis involving the proximal head of the humerus or cervical vertebral bodies, exostosis of the first rib, tumors and hemangioma in the region of the brachial plexus, and intrauterine maladaptation. Kaiser Wilhelm syndrome, neonatal brachial plexus palsy due to placental insufficiency, is probably not a cause of brachial plexus palsy. Obstetrical brachial plexus palsy, the most common alleged cause of neonatal brachial plexus palsy, occurs when the forces generated during labor stretch the brachial plexus beyond its resistance. The probability of obstetrical brachial plexus palsy is directly proportional to the magnitude, acceleration, and cosine of the angle formed by the direction of the vector of the stretching force and the axis of the most vulnerable brachial plexus bundle, and inversely proportional to the resistance of the must vulnerable brachial plexus bundle and of the shoulder girdle muscles, joints, and bones. Since in most nonsurgical cases neither the contribution of each of these factors to the production of the obstetrical brachial plexus palsy nor the proportion of traction and propulsion contributing to the stretch force is known, we concur with prior reports that the term of obstetrical brachial plexus palsy should be substituted by the more inclusive term of birth-related brachial plexus palsy.

  9. Neonatal acute liver failure.

    PubMed

    Taylor, Sarah A; Whitington, Peter F

    2016-05-01

    Neonatal acute liver failure (NALF) is a rare disease about which there is little published data; however, NALF is an extremely important condition as it is distinct from acute liver failure seen in older children and adults. First, unlike acute liver failure in older patients, NALF can be diagnosed in an infant with cirrhosis. This is due to the fetal-neonatal continuum of liver disease, or the principle that neonatal liver failure may be the result of a liver disease that began in utero. Further differences exist in the mechanism of disease, diagnostic principles, and the common etiologies of NALF when compared with pediatric and adult acute liver failure. This review will address many of the distinguishing features of NALF and focus on the most common etiologies of NALF, including gestational alloimmune liver disease (GALD), the most common cause of NALF. Additionally, this review will provide insight into the pathogenesis, diagnosis, and treatment of this rare condition. Liver Transplantation 22 677-685 2016 AASLD. © 2016 American Association for the Study of Liver Diseases.

  10. Neonatal cardiovascular physiology.

    PubMed

    Hines, Michael H

    2013-11-01

    The pediatric surgeon deals with a large number and variety of congenital defects in neonates that frequently involve early surgical intervention and care. Because the neonatal cardiac physiology is unique, starting with the transition from fetal circulation and including differences in calcium metabolism and myocardial microscopic structure and function, it serves the pediatric surgeon well to have a sound understanding of these principles and how they directly and indirectly affect their plans and treatments. In addition, many patients will have associated congenital heart disease that can also dramatically influence not only the surgical and anesthetic care but also the timing and planning of procedures. Finally, the pediatric surgeon is often called upon to treat conditions and complications associated with complex congenital heart disease such as feeding difficulties, bowel perforations, and malrotation in heterotaxy syndromes. In this article, we will review several unique aspects of neonatal cardiac physiology along with the basic physiology of the major groups of congenital heart disease to better prepare the training and practicing pediatric surgeon for care of these complex and often fragile patients. © 2013 Published by Elsevier Inc.

  11. Neonatal abstinence syndrome.

    PubMed

    Jansson, Lauren M; Velez, Martha

    2012-04-01

    This review will discuss the complex nature of maternal and other factors that can affect the infant's display of neonatal abstinence syndrome (NAS), clinical presentation and treatment of NAS, and the impact of recent findings on future directions for research. NAS has traditionally been described as a constellation of signs/symptoms displayed by the neonate upon withdrawal of gestational opioid exposure; however, recent research has advanced our understanding of this disorder. Other psychoactive substances, such as increasingly prescribed serotonin reuptake inhibitors, may produce an independent or synergistic discontinuation syndrome. The wide variability in NAS presentation has generated interest in the interplay of prenatal and postnatal environmental and genetic factors that may moderate or mediate its expression. Finally, recent advances in the treatment of opioid-dependent pregnant women have suggested buprenorphine as an alternative treatment to methadone during pregnancy, largely due to reduced NAS severity in exposed neonates. Physicians should be aware of the complexity of the maternal, fetal, and infant factors that combine to create the infant's display of NAS, and incorporate these aspects into comprehensive assessment and care of the dyad. Further research regarding the pathophysiology and treatment of NAS is warranted.

  12. Neonatal abstinence syndrome.

    PubMed

    Kocherlakota, Prabhakar

    2014-08-01

    Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Withdrawal from licit or illicit substances is becoming more common among neonates in both developed and developing countries. NAS continues to be an important clinical entity throughout much of the world. NAS leads to a constellation of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. Urine or meconium confirmation may assist the diagnosis and management of NAS. The Finnegan scoring system is commonly used to assess the severity of NAS; scoring can be helpful for initiating, monitoring, and terminating treatment in neonates. Nonpharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after nonpharmacological measures or if the infant develops severe withdrawal. Morphine is the most commonly used drug in the treatment of NAS secondary to opioids. An algorithmic approach to the management of infants with NAS is suggested. Breastfeeding is not contraindicated in NAS, unless the mother is taking street drugs, is involved in polydrug abuse, or is infected with HIV. Future studies are required to assess the long-term effects of NAS on children after prenatal exposure. Copyright © 2014 by the American Academy of Pediatrics.

  13. [Neonatal lupus. Case report].

    PubMed

    Alcántara-Salinas, Adriana; Solano-Fiesco, Liborio; Romero-Ramírez, Jorge Armando; Olivera-Solórzano, Florisela; Alonso-Pérez, Nancy Carmencita; Marcos-Cabrera, Liliana; González-Martínez, Rosa Ana

    2012-01-01

    Neonatal lupus has a rare incidence, distinct from systemic lupus erythematosus. This is an acquired autoimmune disease associated with maternal antibodies to proteins Ro / La (SSA /SSB), transferred by the placenta; it represents the prototype of passive transfer of antibodies from mother to child. The disease can affect the skin, heart, and rarely, the hepatobiliary or hematologic systems. Congenital complete heart block is the most severe form of neonatal lupus. In clinical practice it is important to distinguish in utero a complete from an incomplete atrioventricular block (AV) in order to render prompt care. We present the case of a new born female, who was diagnosed with an atrio-ventricular block at 26 weeksí gestation. When the baby was delivered at 38 weeksí gestation, she presented bradycardia (54 xí). On the suspicion of neonatal lupus, we required antinuclear antibodies, anti-Sm, anti-RNP, anti-SS-A and anti-SS-B, which were positive. A bicameral pacemaker was placed uneventfully.

  14. Permeability Parameters Measured with Dynamic Contrast-Enhanced MRI: Correlation with the Extravasation of Evans Blue in a Rat Model of Transient Cerebral Ischemia.

    PubMed

    Choi, Hyun Seok; Ahn, Sung Soo; Shin, Na-Young; Kim, Jinna; Kim, Jae Hyung; Lee, Jong Eun; Lee, Hye Yeon; Heo, Ji Hoe; Lee, Seung-Koo

    2015-01-01

    The purpose of this study was to correlate permeability parameters measured with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a clinical 3-tesla scanner with extravasation of Evans blue in a rat model with transient cerebral ischemia. Sprague-Dawley rats (n = 13) with transient middle cerebral artery occlusion were imaged using a 3-tesla MRI with an 8-channel wrist coil. DCE-MRI was performed 12 hours, 18 hours, and 36 hours after reperfusion. Permeability parameters (K(trans), ve, and vp) from DCE-MRI were calculated. Evans blue was injected after DCE-MRI and extravasation of Evans blue was correlated as a reference with the integrity of the blood-brain barrier. Correlation analysis was performed between permeability parameters and the extravasation of Evans blue. All permeability parameters (K(trans), ve, and vp) showed a linear correlation with extravasation of Evans blue. Among them, K(trans) showed highest values of both the correlation coefficient and the coefficient of determination (0.687 and 0.473 respectively, p < 0.001). Permeability parameters obtained by DCE-MRI at 3-T are well-correlated with Evans blue extravasation, and K(trans) shows the strongest correlation among the tested parameters.

  15. Neonatal Bladder Inflammation Produces Functional Changes and Alters Neuropeptide Content in Bladders of Adult Female Rats

    PubMed Central

    DeBerry, Jennifer; Randich, Alan; Shaffer, Amber D.; Robbins, Meredith T.; Ness, Timothy J.

    2009-01-01

    Neonatal bladder inflammation has been demonstrated to produce hypersensitivity to bladder re-inflammation as an adult. The purpose of this study was to investigate the effects of neonatal urinary bladder inflammation on adult bladder function and structure. Female Sprague-Dawley rats were treated on postnatal days 14-16 with intravesical zymosan or anesthesia alone. At 12-16 weeks of age, micturition frequency and cystometrograms were measured. Similarly treated rats had their bladders removed for measurement of plasma extravasation following intravesical mustard oil, for neuropeptide analysis (CGRP or SubP), or for detailed histological examination. Rats treated with zymosan as neonates exhibited increased micturition frequency, reduced micturition volume thresholds, greater extravasation of Evan's Blue following intravesical mustard oil administration, and greater total bladder content of CGRP and SubP. In contrast, there were no quantitative histological changes in the thickness, fibrosis or mast cells of bladder tissue due to neonatal zymosan treatments. Functional changes in urologic systems observed in adulthood, coupled with the increased neuropeptide content and neurogenic plasma extravasation in adult bladders, suggest that the neonatal bladder inflammation treatment enhanced the number, function and/or neurochemical content of primary afferent neurons. These data support the hypothesis that insults to the urologic system in infancy may contribute to the development of adult bladder hypersensitivity. Perspective Inflammation of the bladder early in life in the rat has multiple sequelae including laboratory measures that suggest an alteration of the neurophysiological substrates related to the bladder. Some painful bladder syndromes in humans have similar characteristics and so may be due to similar mechanisms. PMID:19945355

  16. Neonatal cystic fibrosis screening test

    MedlinePlus

    Cystic fibrosis screening - neonatal; Immunoreactive trypsinogen; IRT test; CF - screening ... better nutrition, growth, and lung function. This screening test helps doctors identify children with CF before they ...

  17. Restrictive management of neonatal polycythemia.

    PubMed

    Morag, Iris; Strauss, Tzipora; Lubin, Daniel; Schushan-Eisen, Irit; Kenet, Gili; Kuint, Jacob

    2011-10-01

    Partial exchange transfusion (PET) is traditionally suggested as treatment for neonates diagnosed with polycythemia. Nevertheless, justification of this treatment is controversial. We evaluated the risk for short-term complications associated with a restrictive treatment protocol for neonatal polycythemia. A retrospective cross-sectional analytical study was conducted. Three treatment groups were defined and managed according to their degree of polycythemia, defined by capillary tube filled with venous blood and manually centrifuged hematocrit: group 1, hematocrit 65 to 69% and no special treatment was recommended; group 2, hematocrit 70 to 75% and intravenous fluids were given and feedings were withheld until hematocrit decreased to < 70%; and group 3, hematocrit ≥ 76% or symptomatic neonates and PET was recommended. During the study period, 190 neonates were diagnosed with polycythemia. The overall rate of short-term complications was 15% (28 neonates). Seizures, proven necrotizing enterocolitis, or thrombosis did not occur in any participating neonates. PET was performed in 31 (16%) neonates. The groups did not differ in their rate of early neonatal morbidities or length of hospitalization. Restrictive treatment for neonatal asymptomatic polycythemia is not associated with an increased risk of short-term complications.

  18. Neonatal herpes simplex virus infections.

    PubMed

    Pinninti, Swetha G; Kimberlin, David W

    2013-04-01

    Neonatal herpes simplex virus infections are uncommon, but because of the morbidity and mortality associated with the infection they are often considered in the differential diagnosis of ill neonates. The use of polymerase chain reaction for diagnosis of central nervous system infections and the development of safe and effective antiviral therapy has revolutionized the diagnosis and management of these infants. Initiation of long-term antiviral suppressive therapy in these infants has led to significant improvement in morbidity. This article summarizes the epidemiology of neonatal herpes simplex virus infections and discusses clinical presentation, diagnosis, management, and follow up of infants with neonatal herpes disease.

  19. Sildenafil Improves Brain Injury Recovery following Term Neonatal Hypoxia-Ischemia in Male Rat Pups.

    PubMed

    Yazdani, Armin; Khoja, Zehra; Johnstone, Aaron; Dale, Laura; Rampakakis, Emmanouil; Wintermark, Pia

    2016-01-01

    Term asphyxiated newborns remain at risk of developing brain injury despite available neuropreventive therapies such as hypothermia. Neurorestorative treatments may be an alternative. This study investigated the effect of sildenafil on brain injury induced by neonatal hypoxia-ischemia (HI) at term-equivalent age. Neonatal HI was induced in male Long-Evans rat pups at postnatal day 10 (P10) by left common carotid ligation followed by a 2-hour exposure to 8% oxygen; sham-operated rat pups served as the control. Both groups were randomized to oral sildenafil or vehicle twice daily for 7 consecutive days. Gait analysis was performed on P27. At P30, the rats were sacrificed, and their brains were extracted. The surfaces of both hemispheres were measured on hematoxylin and eosin-stained brain sections. Mature neurons and endothelial cells were quantified near the infarct boundary zone using immunohistochemistry. HI caused significant gait impairment and a reduction in the size of the left hemisphere. Treatment with sildenafil led to an improvement in the neurological deficits as measured by gait analysis, as well as an improvement in the size of the left hemisphere. Sildenafil, especially at higher doses, also caused a significant increase in the number of neurons near the infarct boundary zone. In conclusion, sildenafil administered after neonatal HI may improve brain injury recovery by promoting neuronal populations.

  20. Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design.

    PubMed

    Garne, Kristina; Brødsgaard, Anne; Zachariassen, Gitte; Clemensen, Jane

    2016-07-08

    For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. To identify parental needs when wanting to provide neonatal home care supported by telemedicine. The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a "bell cord" to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using telemedicine.

  1. Telemedicine in Neonatal Home Care: Identifying Parental Needs Through Participatory Design

    PubMed Central

    Brødsgaard, Anne; Zachariassen, Gitte; Clemensen, Jane

    2016-01-01

    Background For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. Objective To identify parental needs when wanting to provide neonatal home care supported by telemedicine. Methods The study used participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care with telemedicine support. A total of 9 parents with preterm infants assigned to a neonatal home care program and 10 parents with preterm infants admitted to a neonatal unit participated in individual interviews and focus group interviews, respectively. Results Three overall themes were identified: being a family, parent self-efficacy, and nurse-provided security. Parents expressed desire for the following: (1) a telemedicine device to serve as a “bell cord” to the neonatal unit, giving 24-hour access to nurses, (2) video-conferencing to provide security at home, (3) timely written email communication with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. Conclusions Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when combined with nursing guidance. Parents did not request hands-on support for infant care, but instead expressed a need for communication and guidance, which could be met using

  2. Reappraisal of twinning: epidemiology and outcome in the early neonatal period

    PubMed Central

    Gupta, Priyanka; Faridi, Mohammad Moonis Akbar; Goel, Neerja; Zaidi, Zeashan

    2014-01-01

    INTRODUCTION The present study aimed to determine the epidemiology, maternal complications and adverse neonatal outcomes associated with twin births at a tertiary care hospital in India. METHODS A prospective observational study was conducted on all successively born twin pairs (≥ 23 weeks of gestation) and their mothers from January to September 2005. Main outcome measures included maternal medical/obstetric complications, labour characteristics and the morbidities/mortality observed during the early neonatal period. RESULTS The twinning rate was 1 in 54 deliveries. Around 10% of mothers had a predisposition for twinning in the form of familial tendency or consumption of clomiphene. Anaemia (85%) was the most common maternal complication, followed by gestational hypertension (17%). Nearly one-third of births were delivered via Caesarean section. Prematurity (61%) was the most common neonatal complication followed by early-onset neonatal sepsis (21%). The risk of early neonatal death was 27%. Shorter gestation and low birth weight were significantly associated with adverse neonatal outcome (p < 0.05). Factors such as chorionicity, mode of delivery, birth order, inter-twin delivery time interval, gender and intra-pair birth weight discordance did not affect neonatal morbidity or mortality (p ≥ 0.05). CONCLUSION The rates of maternal complications and early neonatal morbidities/mortality were quite high in twin gestations. Except for the prematurity and low birth weight, none of the other factors, including inter-twin delivery time interval of more than 15 mins, were found to affect neonatal outcome. PMID:25017406

  3. Evans blue as a simple method to discriminate mosquitoes' feeding choice on small laboratory animals.

    PubMed

    Maciel, Ceres; Fujita, André; Gueroni, Daniele I; Ramos, Anderson D; Capurro, Margareth L; Sá-Nunes, Anderson

    2014-01-01

    Temperature, humidity, vision, and particularly odor, are external cues that play essential roles to mosquito blood feeding and oviposition. Entomological and behavioral studies employ well-established methods to evaluate mosquito attraction or repellency and to identify the source of the blood meal. Despite the efficacy of such methods, the costs involved in the production or acquisition of all parts, components and the chemical reagents involved are unaffordable for most researchers from poor countries. Thus, a simple and relatively low-cost method capable of evaluating mosquito preferences and the blood volume ingested is desirable. By using Evans blue (EB) vital dye and few standard laboratory supplies, we developed and validated a system capable of evaluating mosquito's choice between two different host sources of blood. EB-injected and PBS-injected mice submitted to a number of situations were placed side by side on the top of a rounded recipient covered with tulle fabric and containing Aedes aegypti mosquitoes. Homogenates from engorged mosquitoes clearly revealed the blood source (EB- or PBS-injected host), either visually or spectrometrically. This method was able to estimate the number of engorded mosquitoes, the volume of blood ingested, the efficacy of a commercial repellent and the attractant effects of black color and human sweat. Despite the obvious limitations due to its simplicity and to the dependence of a live source of blood, the present method can be used to assess a number of host variables (diet, aging, immunity, etc) and optimized for several aspects of mosquito blood feeding and vector-host interactions. Thus, it is proposed as an alternative to field studies, and it could be used for initial screenings of chemical compound candidates for repellents or attractants, since it replicates natural conditions of exposure to mosquitoes in a laboratory environment.

  4. Methylphenidate alters flash-evoked potentials, body temperature, and behavior in Long-Evans rats.

    PubMed

    Hetzler, Bruce E; Meckel, Katherine R; Stickle, Bruce A

    2014-01-01

    This experiment examined the effects of methylphenidate hydrochloride on flash-evoked potentials (FEPs) recorded from the visual cortex (VC) and superior colliculus (SC) of chronically implanted male Long-Evans rats, as well as on body temperature and open field behavior. FEPs were recorded at 10, 20 and 40 min following intraperitoneal injections of saline, and of doses of 0.7, 2.9, and 11.6 mg/kg methylphenidate on separate days. The 0.7 mg/kg dose did not produce significant effects. In the VC, following administration of the 11.6 mg/kg dose of methylphenidate the amplitude of components P83, N146, and P232 decreased, the amplitude of component N64 briefly increased and components P23, N30, N40, and P48 were unchanged in amplitude. In the SC, component P29 was unaffected, while components P38 and N51 were reduced in amplitude by the 11.6 mg/kg dose of methylphenidate. Peak latencies of components N40, P48, P83, and N146 in the VC and component P38 in the SC were increased by the 11.6 mg/kg dose of methylphenidate. When body temperature was recorded 45 min after drug administration, a mild dose-dependent hypothermia was found with the 2.9 and 11.6 mg/kg methylphenidate doses, suggesting that this may have contributed to the increased latencies. In subsequent open field observations, both line crossings and rearings were significantly increased by the 11.6 mg/kg dose. Increased movement into the center of the testing area was also observed, which could be a sign of increased exploration and reduced anxiety following methylphenidate. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. The subglacial environment of Evans Ice Stream, West Antarctica from radio-echo sounding

    NASA Astrophysics Data System (ADS)

    Ashmore, David W.; Bingham, Robert G.; Hindmarsh, Richard R. C. A.

    2013-04-01

    Airborne ice-penetrating radar (radio-echo sounding) is the most efficient method for investigating subglacial environments across polar ice-sheets. Theoretically, analyses of the shape and amplitude of the basal reflector can yield physical information on subglacial conditions. Most notably, due to the high relative permittivity of liquid water a high amplitude reflection indicates a temperate (unfrozen) bed, whose diagnosis is pertinent for understanding controls on ice dynamics and, in particular, tributary and fast-flow phenomena. However exploiting datasets in this way remains difficult as consistent algorithms for the quantitative analysis of basal reflectors are yet to be established, with perhaps the greatest difficulty being posed by characterising how the ice itself attenuates the radar signal. In this study we consider this problem using a 150 MHz centre-frequency airborne radar survey of Evans Ice Stream, a major West Antarctic ice stream, collected by the British Antarctic Survey in 2006/07. Using temperature output from a 3D finite difference ice-sheet model we derive a spatially varying parameterisation of englacial attenuation. The peak amplitude of the ice-bed reflection is extracted and corrected for geometric spreading, variations in radar power output and attenuation. We find a clear association with fast flow regions and a bimodal frequency distribution, separated by 10-15 dB, consistent with the reflectivity of the subglacial interface being dominated by the presence of subglacial water. In order to develop these results we present a comparison with a surface roughness metric, based on landscape statistics and a first order analysis of the reflection shape. We discuss the glaciological and geophysical implications of these observations. This study demonstrates the potential for the exploitation of existing radar datasets using relatively straightforward techniques.

  6. Brain ventricular size in healthy elderly: comparison between Evans index and volume measurement.

    PubMed

    Ambarki, Khalid; Israelsson, Hanna; Wåhlin, Anders; Birgander, Richard; Eklund, Anders; Malm, Jan

    2010-07-01

    A precise definition of ventricular enlargement is important in the diagnosis of hydrocephalus as well as in assessing central atrophy. The Evans index (EI), a linear ratio between the maximal frontal horn width and the cranium diameter, has been extensively used as an indirect marker of ventricular volume (VV). With modern imaging techniques, brain volume can be directly measured. To determine reference values of intracranial volumes in healthy elderly individuals and to correlate volumes with the EI. Magnetic resonance imaging (3 T) was performed in 46 healthy white elderly subjects (mean age+/-standard deviation, 71+/-6 years) and in 20 patients (74+/-7 years) with large ventricles according to visual inspection. VV, relative VV (RVV), and EI were assessed. Ventricular dilation was defined using VV and EI by a value above the 95th percentile range for healthy elderly individuals. In healthy elderly subjects, we found VV=37+/-18 mL, RVV=2.47+/-1.17%, and EI=0.281+/-0.027. Including the patients, there was a strong correlation between EI and VV (R=0.94) as well as between EI and RVV (R=0.95). However, because of a wide 95% prediction interval (VV: +/-45 mL; RVV: +/-2.54%), EI did not give a sufficiently good estimate of VV and RVV. VV (or RVV) and the EI reflect different properties. The exclusive use of EI in clinical studies as a marker of enlarged ventricles should be questioned. We suggest that the definition of dilated ventricles in white elderly individuals be defined as VV>77 mL or RVV>4.96 %. Future studies should compare intracranial volumes with clinical characteristics and prognosis.

  7. Evans Blue as a Simple Method to Discriminate Mosquitoes’ Feeding Choice on Small Laboratory Animals

    PubMed Central

    Maciel, Ceres; Fujita, André; Gueroni, Daniele I.; Ramos, Anderson D.; Capurro, Margareth L.; Sá-Nunes, Anderson

    2014-01-01

    Background Temperature, humidity, vision, and particularly odor, are external cues that play essential roles to mosquito blood feeding and oviposition. Entomological and behavioral studies employ well-established methods to evaluate mosquito attraction or repellency and to identify the source of the blood meal. Despite the efficacy of such methods, the costs involved in the production or acquisition of all parts, components and the chemical reagents involved are unaffordable for most researchers from poor countries. Thus, a simple and relatively low-cost method capable of evaluating mosquito preferences and the blood volume ingested is desirable. Principal Findings By using Evans blue (EB) vital dye and few standard laboratory supplies, we developed and validated a system capable of evaluating mosquito’s choice between two different host sources of blood. EB-injected and PBS-injected mice submitted to a number of situations were placed side by side on the top of a rounded recipient covered with tulle fabric and containing Aedes aegypti mosquitoes. Homogenates from engorged mosquitoes clearly revealed the blood source (EB- or PBS-injected host), either visually or spectrometrically. This method was able to estimate the number of engorded mosquitoes, the volume of blood ingested, the efficacy of a commercial repellent and the attractant effects of black color and human sweat. Significance Despite the obvious limitations due to its simplicity and to the dependence of a live source of blood, the present method can be used to assess a number of host variables (diet, aging, immunity, etc) and optimized for several aspects of mosquito blood feeding and vector-host interactions. Thus, it is proposed as an alternative to field studies, and it could be used for initial screenings of chemical compound candidates for repellents or attractants, since it replicates natural conditions of exposure to mosquitoes in a laboratory environment. PMID:25333369

  8. Organ-specific extravasation of albumin-bound Evans blue during nonresuscitated hemorrhagic shock in rats.

    PubMed

    Schumacher, Jan; Binkowski, Kathrin; Dendorfer, Andreas; Klotz, Karl-Friedrich

    2003-12-01

    Shock-induced enhanced capillary permeability is associated with alterations in the interstitial matrix composition and contributes to organ damage. This study was designed to evaluate albumin extravasation in various organ tissues during severe, hemorrhagic shock without fluid resuscitation and reperfusion. Target value of hemorrhagic shock was a reduction of cardiac output (CO) by 50% induced by removal of blood. Twelve anesthetized Sprague-Dawley rats (260-325 g) kept under continuous hemodynamic monitoring were randomly assigned to a group of hemorrhagic shock (n = 6) and a control group of normovolemic animals (n = 6). After 30 min of shock 50 mg/kg b.w. Evans blue (EB) was injected intravenously followed by an incubation period of 20 min. Exsanguination and wash out of the intravascular space was performed by a pressure-controlled perfusion with heparinized saline before harvesting organs to quantify albumin-bound EB extravasation. We found that withdrawal of 4.7 +/- 0.4 mL (mean, +/-SEM) blood, which accounts for 21.1% of the calculated total blood volume, resulted in a reduction of CO from 36.1 +/- 3.1 to 19.4 +/- 2.7 mL/min. Simultaneously, MAP decreased from 98 +/- 6 to 40 +/- 1 mmHg. In hemorrhaged rats, the interstitial concentration of EB in lung and kidney was significantly higher than observed in intact animals, whereas heart, spleen, liver, ileum, skeletal muscle, and skin showed no significant microvascular damage. We conclude that despite the absence of fluid resuscitation and reperfusion, microvascular damage in lung and kidney is evident within the first thirty minutes of hemorrhagic shock.

  9. Prenatal protein level impacts homing behavior in Long-Evans rat pups.

    PubMed

    Fischer, L K; McGaughy, J A; Bradshaw, S E; Weissner, W J; Amaral, A C; Rosene, D L; Mokler, D J; Fitzmaurice, G M; Galler, J R

    2016-06-01

    This study assessed the effect of varying prenatal protein levels on the development of homing behavior in rat pups. Long-Evans rats were fed one of the four isocaloric diets containing 6% (n = 7 litters), 12% (n = 9), 18% (n = 9), or 25% (n = 10) casein prior to mating and throughout pregnancy. At birth, litters were fostered to well-nourished control mothers fed a 25% casein diet during pregnancy, and an adequate protein diet (25% casein) was provided to weaning. On postnatal days 5, 7, 9, 11, and 13, homing behaviors, including activity levels, rate of successful returns to the nest quadrant and latencies to reach the nest over a 3-minute test period were recorded from two starting positions in the home cage. Adult body and brain weights were obtained at sacrifice (postnatal day 130 or 200). Growth was impaired in pups whose mothers were fed a 6% or, to a lesser extent, a 12% casein diet relative to pups whose mothers were fed the 18 and 25% casein diets. The 6 and 12% prenatal protein levels resulted in lower activity levels, with the greatest reduction on postnatal day 13. However, only the 6% pups had reduced success and higher latencies in reaching the nest quadrant when compared with pups from the three other nutrition groups. Latency in reaching the nest quadrant was significantly and negatively associated with adult brain weight. Home orientation is a sensitive measure of developmental deficits associated with variations in prenatal protein levels, including levels of protein deficiency that do not lead to overt growth failure.

  10. Opioidergic and dopaminergic modulation of cost/benefit decision-making in Long Evans Rats.

    PubMed

    Morales, Ileana; Currie, Paul J; Hackenberg, Timothy D; Pastor, Raúl

    2017-10-01

    Eating disorders are associated with impaired decision-making and dysfunctional reward-related neurochemistry. The present study examined the potential contributions of dopamine and opioid signaling to these processes using two different decision-making tasks. In one task, Long Evans Rats chose between working for a preferred food (high-carbohydrate banana-flavored sucrose pellets) by lever pressing on a progressive-ratio schedule of reinforcement vs. obtaining less preferred laboratory chow that was concurrently available. In a second (effort-free) task, rats chose between the same two reinforcers when they were both available freely. Rats were trained in these tasks before receiving haloperidol (0.00, 0.05, 0.10mg/kg, intraperitoneally (i.p.)) or naloxone (0.0, 1.5, 3.0mg/kg, i.p.). In the first task, haloperidol decreased breakpoint, lever presses, number of reinforcers earned, and increased chow intake, whereas naloxone decreased breakpoint and number of reinforcers earned but had no effect on chow consumption. In the effort-free task, haloperidol reduced intakes of both foods without affecting preference, whereas naloxone selectively reduced the consumption of banana-pellets. The present findings support converging evidence suggesting that DA signaling affects processes more closely related to appetitive motivation, leaving other components of motivation unchanged. By contrast, opioid signaling appears to mediate aspects of hedonic feeding by selectively altering intakes of highly palatable foods. For preferred foods, both appetitive and consummatory aspects of food intake were altered by opioid receptor antagonism. Our findings argue against a general suppression of appetite by either compound, as appetite manipulations have been shown to unselectively alter intakes of both types of food regardless of the task employed. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Neonatal Marfan Syndrome: Report of a Case with an Inherited Splicing Mutation outside the Neonatal Domain.

    PubMed

    Le Gloan, Laurianne; Hauet, Quentin; David, Albert; Hanna, Nadine; Arfeuille, Chloé; Arnaud, Pauline; Boileau, Catherine; Romefort, Bénédicte; Benbrik, Nadir; Gournay, Véronique; Joram, Nicolas; Baron, Olivier; Isidor, Bertrand

    2016-02-01

    We report a child and her mother affected by Marfan syndrome. The child presented with a phenotype of neonatal Marfan syndrome, revealed by acute and refractory heart failure, finally leading to death within the first 4 months of life. Her mother had a common clinical presentation. Genetic analysis revealed an inherited FBN1 mutation. This intronic mutation (c.6163+3_6163+6del), undescribed to date, leads to exon 49 skipping, corresponding to in-frame deletion of 42 amino acids (p.Ile2014_Asp2055del). FBN1 next-generation sequencing did not show any argument for mosaicism. Association in the same family of severe neonatal and classical Marfan syndrome illustrates the intrafamilial phenotype variability.

  12. Neonatal Marfan Syndrome: Report of a Case with an Inherited Splicing Mutation outside the Neonatal Domain

    PubMed Central

    Le Gloan, Laurianne; Hauet, Quentin; David, Albert; Hanna, Nadine; Arfeuille, Chloé; Arnaud, Pauline; Boileau, Catherine; Romefort, Bénédicte; Benbrik, Nadir; Gournay, Véronique; Joram, Nicolas; Baron, Olivier; Isidor, Bertrand

    2016-01-01

    We report a child and her mother affected by Marfan syndrome. The child presented with a phenotype of neonatal Marfan syndrome, revealed by acute and refractory heart failure, finally leading to death within the first 4 months of life. Her mother had a common clinical presentation. Genetic analysis revealed an inherited FBN1 mutation. This intronic mutation (c.6163+3_6163+6del), undescribed to date, leads to exon 49 skipping, corresponding to in-frame deletion of 42 amino acids (p.Ile2014_Asp2055del). FBN1 next-generation sequencing did not show any argument for mosaicism. Association in the same family of severe neonatal and classical Marfan syndrome illustrates the intrafamilial phenotype variability. PMID:27022329

  13. Elimination of an Infestation of Rat Fur Mites (Radfordia ensifera) from a Colony of Long Evans Rats, Using the Micro-dot Technique for Topical Administration of 1% Ivermectin.

    PubMed

    Kondo, Sylvia; Taylor, Andrew; Chun, Stewart

    1998-01-01

    Micro-dot delivery of 1% ivermectin was used in an effort to eliminate an infestation of rat fur mites (Radfordia ensifera) from a conventionally housed colony of Long Evans rats. The colony was used for breeding as well as for behavioral testing. A micropipette was used to apply a 1% solution of ivermectin (2 mg/kg of body weight) to the skin on the dorsal aspect of the shoulder. Three treatments were applied at approximately 2-week intervals. All rats in the colony were treated. However, to avoid toxicity to neonates, nursing females and their pups (control group) received mineral oil in lieu of ivermectin until after weaning, at which time they also were treated with ivermectin. During the treatment phase, skin scrapings were used to detect mites. Control rats remained positive for fur mites when treated with mineral oil. After 3 applications of ivermectin, all rats were found to be free of mites. During the posttreatment phase, skin scrapings, dorsal tape tests, and a washing method were performed on euthanatized rats to detect mites. Rats tested up to 129 days (18 weeks) after ivermectin treatment were still free of mites. In a breeding colony composed of rats of various sizes and ages, micropipette delivery of ivermectin allowed for accurate dosing to eliminate fur mites, while preventing inadvertent toxicosis. We did not detect obvious adverse effects on the breeding program or on the behavioral studies in which these rats were subsequently used, nor did we detect morbidity or mortality associated with ivermectin administration.

  14. Rapid Evolution of the CD8+ TCR Repertoire in Neonatal Mice.

    PubMed

    Carey, Alison J; Gracias, Donald T; Thayer, Jillian L; Boesteanu, Alina C; Kumova, Ogan K; Mueller, Yvonne M; Hope, Jennifer L; Fraietta, Joseph A; van Zessen, David B H; Katsikis, Peter D

    2016-03-15

    Currently, there is little consensus regarding the most appropriate animal model to study acute infection and the virus-specific CD8(+) T cell (CTL) responses in neonates. TCRβ high-throughput sequencing in naive CTL of differently aged neonatal mice was performed, which demonstrated differential Vβ family gene usage. Using an acute influenza infection model, we examined the TCR repertoire of the CTL response in neonatal and adult mice infected with influenza type A virus. Three-day-old mice mounted a greatly reduced primary NP(366-374)-specific CTL response when compared with 7-d-old and adult mice, whereas secondary CTL responses were normal. Analysis of NP(366-374)-specific CTL TCR repertoire revealed different Vβ gene usage and greatly reduced public clonotypes in 3-d-old neonates. This could underlie the impaired CTL response in these neonates. To directly test this, we examined whether controlling the TCR would restore neonatal CTL responses. We performed adoptive transfers of both nontransgenic and TCR-transgenic OVA(257-264)-specific (OT-I) CD8(+) T cells into influenza-infected hosts, which revealed that naive neonatal and adult OT-I cells expand equally well in neonatal and adult hosts. In contrast, nontransgenic neonatal CD8(+) T cells when transferred into adults failed to expand. We further demonstrate that differences in TCR avidity may contribute to decreased expansion of the endogenous neonatal CTL. These studies highlight the rapid evolution of the neonatal TCR repertoire during the first week of life and show that impaired neonatal CTL immunity results from an immature TCR repertoire, rather than intrinsic signaling defects or a suppressive environment.

  15. Neonatal haemostasis and the management of neonatal thrombosis.

    PubMed

    Will, Andrew

    2015-05-01

    Two detailed reviews of the management of neonatal thrombosis were published in 2012; one was an up-dated version of guidance first issued in 2004 and the other was a comprehensive review. Both of these publications gave very similar advice regarding the practical aspects of the indications, dosage and management of antithrombotic therapy. The authors stated that the evidence supporting most of their recommendations for anti-thrombotic therapy in neonates remained weak and so the therapy for a neonate with a thrombosis has to be based on an individualized assessment of estimated risk versus potential benefit. The aim of this present review is to give the treating physician an outline of the unique physiology of neonatal coagulation and how this affects the monitoring, dosing and even the choice of therapeutic strategy for the management of thrombosis in the neonate. © 2015 John Wiley & Sons Ltd.

  16. Nursing supports neonatal porcine testicular development.

    PubMed

    Rahman, K M; Lovich, J E; Lam, C; Camp, M E; Wiley, A A; Bartol, F F; Bagnell, C A

    2014-07-01

    The lactocrine hypothesis suggests a mechanism whereby milk-borne bioactive factors delivered to nursing offspring affect development of neonatal tissues. The objective of this study was to assess whether nursing affects testicular development in neonatal boars as reflected by: (1) Sertoli cell number and proliferation measured by GATA-4 expression and proliferating cell nuclear antigen immunostaining patterns; (2) Leydig cell development and steroidogenic activity as reflected by insulin-like factor 3 (INSL3), and P450 side chain cleavage (scc) enzyme expression; and (3) expression of estrogen receptor-alpha (ESR1), vascular endothelial growth factor (VEGF) A, and relaxin family peptide receptor (RXFP) 1. At birth, boars were randomly assigned (n = 6-7/group) to nurse ad libitum or to be pan fed porcine milk replacer for 48 h. Testes were collected from boars at birth, before nursing and from nursed and replacer-fed boars at 50 h on postnatal day (PND) 2. Sertoli cell proliferating cell nuclear antigen labeling index increased (P < 0.01) from birth to PND 2 in nursed, but not in replacer-fed boars. Sertoli cell number and testicular GATA-4 protein levels increased (P < 0.01) from PND 0 to PND 2 only in nursed boars. Neither age nor nursing affected testicular INSL3, P450scc, ESR1, or VEGFA levels. However, testicular relaxin family peptide receptor 1 (RXFP1) levels increased (P < 0.01) with age and were greater in replacer-fed boars on PND 2. Results suggest that nursing supports neonatal porcine testicular development and provide additional evidence for the importance of lactocrine signaling in pigs.

  17. Neonatal intensive care unit lighting: update and recommendations.

    PubMed

    Rodríguez, Roberto G; Pattini, Andrea E

    2016-08-01

    Achieving adequate lighting in neonatal intensive care units is a major challenge: in addition to the usual considerations of visual performance, cost, energy and aesthetics, there appear different biological needs of patients, health care providers and family members. Communicational aspects of light, its role as a facilitator of the visual function of doctors and nurses, and its effects on the newborn infant physiology and development were addressed in order to review the effects of light (natural and artificial) within neonatal care with a focus on development. The role of light in regulating the newborn infant circadian cycle in particular and the therapeutic use of light in general were also reviewed. For each aspect, practical recommendations were specified for a proper well-lit environment in neonatal intensive care units.

  18. [Natal and neonatal teeth].

    PubMed

    Baumgart, Manuela; Lussi, Adrian

    2006-01-01

    Natal teeth have been defined as teeth which are present at birth, while neonatal teeth erupt during the first 30 days. Their occurrence is rare, the prevalence ranges from 1:2000 to 1:3000 with a higher frequency in the lip and palate clefts and syndroms. In about 85% natal or neonatal teeth are lower central incisors (60% in pairs), rare are upper teeth, molars and multiple teeth. In almost 90% they are part of the deciduous dentition. A lot of possible causes of early eruption are discussed, but only the relation to hereditary factors seems to be evident. An autosomal dominant trait is often described. The appearance of these teeth is dependent on the degree of maturity, but most of the time it is loose, small, discoloured and hypoplastic. Histologically, enamel hypoplasia with normal prism structure is apparent. No significant disturbances of the dentin structures are observed, only cervically dentin becomes atubular with spaces and enclosed cells. A large vascular pulp and failure of root formation are further investigations. Our microhardness measurements showed values from 24.3-32.4 KHN for enamel and 48.3-62.2 KHN for dentin, while normal deciduous teeth have an enamel hardness of 322.0 +/- 17.5 KHN. The thickness of enamel was never more than 280 microm compared to up to 1200 microm in normal teeth. This shows the retarded development of natal and neonatal teeth, because mineralization has not finished at the time of birth. In accordance with developmental age tooth structure and appearence are normal. In consideration of complications as Riga-Fede-disease, feeding problems, possibility of infection and hypermobility most of the time extraction is the treatment of choice, but in the interest of protecting the child this decision should be made carefully.

  19. The conundrum of neonatal coagulopathy.

    PubMed

    Revel-Vilk, Shoshana

    2012-01-01

    The maturation and postnatal development of the human coagulation system was first studied and described more than 20 years ago. These older studies, supported by more recent data, confirm the significant and important differences in the physiology of coagulation and fibrinolysis in neonates and young children compared with older children and adults. Subsequently, significant differences were also described in the physiology of primary hemostasis and in global in vitro tests for hemostasis. These differences, which mostly reflect the immaturity of the neonatal hemostasis system, are functionally balanced. Healthy neonates show no signs of easy bruising or other bleeding diathesis and no increased tendency to thrombosis for any given stimulus compared with adults. Systemic diseases may affect hemostasis, predisposing ill neonates to increased hemorrhagic or thrombotic complications. The immaturity of the hemostasis system in preterm and very-low-birth-weight neonates may contribute to a higher risk for intraventricular hemorrhage. Therapies targeting the hemostasis system can be effective for preventing and treating these events. The concept of "neonatal coagulopathy" has an important impact on both the diagnosis and management of hemorrhagic or thrombotic events in neonates. For diagnosis of hemostasis disorders, diagnostic laboratories processing pediatric samples should use age-, analyzer-, and reagent-appropriate reference ranges. Age-specific guidelines should be followed for the management of neonates with hemostatic disorders.

  20. Neonatal opioid withdrawal syndrome.

    PubMed

    Sutter, Mary Beth; Leeman, Lawrence; Hsi, Andrew

    2014-06-01

    Neonatal opioid withdrawal syndrome is common due to the current opioid addiction epidemic. Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Neonatal drug withdrawal.

    PubMed

    Hudak, Mark L; Tan, Rosemarie C

    2012-02-01

    Maternal use of certain drugs during pregnancy can result in transient neonatal signs consistent with withdrawal or acute toxicity or cause sustained signs consistent with a lasting drug effect. In addition, hospitalized infants who are treated with opioids or benzodiazepines to provide analgesia or sedation may be at risk for manifesting signs of withdrawal. This statement updates information about the clinical presentation of infants exposed to intrauterine drugs and the therapeutic options for treatment of withdrawal and is expanded to include evidence-based approaches to the management of the hospitalized infant who requires weaning from analgesics or sedatives.

  2. Eye pathologies in neonates

    PubMed Central

    Mansoor, Nyaish; Mansoor, Tihami; Ahmed, Mansoor

    2016-01-01

    In the United Kingdom, newborn assessment incorporates a screening eye examination for any structural abnormalities, observation of neonate's visual behaviour and direct ophthalmoscopy examination looking for red reflex. Early identification and immediate management of eye related pathologies should commence soon after birth as early diagnosis and prompt intervention may have significant impact on the prognosis for many potentially blinding but treatable disorders such as congenital cataracts and retinoblastoma. If left undetected and untreated, such problems may potentially lead to irreversible damage to the vision which persists into adulthood resulting in lack of self-confidence together with difficulties in educational attainment and job opportunities. PMID:28003988

  3. Neonatal screening: ethical aspects.

    PubMed

    Hermerén, G

    1999-12-01

    The purpose of this paper is to give an overview of the ethical issues raised by neonatal screening for cystic fibrosis and to propose a structure for the ethical analysis of these issues. The structure is based on an analysis of some of the most common shortcomings of ethical analyses. The structure needs to be supplemented by facts about the present state of the art concerning effects and costs of the various screening and treatment alternatives. Such information is provided by other contributions to these proceedings.

  4. Pretreatment with Evans blue, a stimulator of BK(Ca) channels, inhibits compound 48/80-induced shock, systemic inflammation, and mast cell degranulation in the rat.

    PubMed

    Fu, Yaw-Syan; Kuo, Su-Yu; Lin, Hsuan-Yea; Chen, Chun-Lin; Huang, Shi-Ying; Wen, Zhi-Hong; Lee, Kun-Zer; Huang, Hung-Tu

    2015-09-01

    The present study demonstrated that intravenous injection of a high dose of compound 48/80 to the rat induced 50% drop, within a few min, in the mean arterial pressure and pulse pressure as well as systemic inflammatory plasma leakage that might lead to circulatory and respiratory failure. We also investigated whether pretreatment with Evans blue, a stimulator of BK(Ca) channels, could exert inhibitory effect against compound C48/80-induced allergic circulatory shock and systemic inflammation. Different groups of Sprague-Dawley rats received an intravenous injection of a dose of Evans blue (0, 5, 10, or 50 mg/kg) just 20 s prior to injection of compound 48/80 (200 μg/kg, over 2 min). The present study found that pretreatment with Evans blue in a dose of 10 or 50 mg/kg exerted acute inhibitory effect on compound 48/80-induced sudden drop in mean arterial and pulse pressures. We also showed that pretreatment with Evans blue in a dose of 5, 10, or 50 mg/kg significantly inhibited compound 48/80-induced extensive plasma extravasation, mast cell degranulation, and edema formation in various organs including the airways, esophagus, and skin. Pretreatment with Evans blue 50 mg/kg 1 h earlier exhibited longer-term inhibitory effect on compound 48/80-induced arterial hypotension and systemic inflammation. We concluded that Evans blue pretreatment prevented rats from compound 48/80-triggered allergic shock and systemic inflammation, possibly mainly through inhibition of mast cell degranulation. Evans blue might be potentially useful in elucidating the mechanism and acting as a therapeutic agent of allergic shock and systemic inflammation.

  5. Neonatal abstinence syndrome: therapeutic interventions.

    PubMed

    Sublett, Juli

    2013-03-01

    Neonatal Abstinence Syndrome (NAS) occurs in infants exposed to opiates or illicit drugs during pregnancy. It can be severe and cause long hospital stays after birth and with symptoms up to 6 months after birth. Pharmacologic interventions are commonly used as treatment for NAS; however, their safety and efficacy are not fully recognized. Pharmacologic treatments for NAS include medications such as methadone, buprenorphine, morphine, and phenobarbital. Nonpharmacologic interventions and complementary therapies have been documented in neonates. However, there are gaps in the literature regarding use of these therapies for neonatal withdrawal. This article provides an overview of the possible risks, benefits, and outcomes of pharmacologic and complementary therapies in the neonatal population, and illustrates the gaps in knowledge related to their use for neonatal withdrawal.

  6. Neonates with extra-renal pelvis: the first 2 years.

    PubMed

    Katzir, Ze'ev; Witzling, Michaela; Nikolov, Gallina; Gvirtz, Gabriela; Arbel, Eliana; Kohelet, David; Boaz, Mona; Smetana, Shmuel; Lorberboym, Mordechai

    2005-06-01

    Extra-renal pelvis (ERpel) is a common ultrasonographic finding among neonates who have undergone recurrent ultrasound examinations for a better definition of prenatal renal pelvic dilatation. This study tries to determine whether or not ERpel has important prognostic implications. Seventy-nine neonates (17 female) were examined. All had a diagnosis of prenatal renal pelvis dilatation, which was shown by postnatal ultrasound to be ERpel. Sixty ERpel neonates were examined 1.5 months to 2.5 months after the ultrasound (US) diagnosis by both Tc-99m diethylene triamine penta-acetic acid (DPTA) dynamic renal scanning and (99m)Tc-pertechnetate direct cystography. Clinical assessment, urine cultures and renal ultrasound follow-up were maintained for 2 years. The proportion of urinary tract infections (UTIs) in patients with ERpel was compared with that of the total neonatal and infantile population with normal US scans in the region of our hospital. Associated minor congenital malformations were found in 12 of 79 neonates (15.2%). Four had a family history of ERpel. Among 60 neonates who underwent renal scanning, 36 (60%) were found to have urinary retention in the collecting system. Another nine (15%) had vesico-ureteral (VU) reflux, of which seven had urinary retention. Fifteen (25%) showed normal isotope imaging. Urinary tract infection was diagnosed in 16 ERpel neonates in whom only one exhibited VU reflux (grade 2). The incidence of neonatal UTI in the ERpel group was more than that of either neonatal or infantile UTI in those with normal US scans in the local population (20.2% vs 1.2% and 4.3%, respectively). Fifty-three infants completed a 2-year follow-up. Repeat renal ultrasonography indicated that one infant (1.8%) had developed bilateral hydronephrosis, 12 (22.6%) had unchanged findings, 18 (40%) showed an improvement (decrease of ERpel width or resolution in one side) and, in 22 (41.5%) infants, the condition had resolved. No clinical or kidney function

  7. [Transient neonatal myasthenia gravis].

    PubMed

    Licht, C; Model, P; Kribs, A; Herkenrath, P; Michalk, D V; Haupt, W F; Göhring, U J; Roth, B

    2002-08-01

    Ten to twenty percent of the offspring of mothers suffering from myasthenia gravis (MG) also develop transient neonatal MG, since maternal antibodies are able to cross the placenta. We report the course of two newborns of a mother with MG and a healthy father. The first pregnancy was complicated during the 3rd trimester by a hydramnion. The newborn presented with generalized muscle weakness, respiratory distress, weak sounding, anaemia, and poor sucking. Mechanical ventilation was necessary. Confirmation of the diagnosis was achieved by the result of repetitive muscle stimulation, showing a typical decrement in the EMG, and measurement of serum antiacetylcholin receptor antibodies. For 3 months, the infant was treated with neostigmin (cholinesterase inhibitor). After 26 days of hospitalization, the patient was released and followed up regularly. Myasthenic symptoms completely resolved. Side effects of the treatment were not observed. The course of the second pregnancy was normal. This second newborn was healthy. Our case report is remarkable for the very different presentation of two children of the same mother with MG during pregnancy and after delivery, with one child developing severe transient neonatal MG, initially requiring intensive care unit (ICU) treatment followed by quick recovery, and one child being healthy. We also present a score for monitoring the clinical course and adjusting anticholinesterase therapy accordingly.

  8. Neonatal compartment syndrome

    PubMed Central

    Martin, B; Treharne, L

    2016-01-01

    A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necrotic tissue, he underwent split-thickness skin grafting of the resultant defects of his forearm, hand and digits. At the clinic follow-up appointment two months after the procedure, he was found to have developed severe flexion contractures despite regular outpatient hand therapy and splintage. He has had further reconstruction with contracture release, use of artificial dermal matrix, and K-wire fixation of the thumb and wrist. Despite this, the long term outcome is likely to be an arm with poor function. The key learning point from this case is that despite prompt transfer, diagnosis and appropriate surgical management, the outcome for neonatal compartment syndrome may still be poor. PMID:27138850

  9. Hypernatremia in the Neonate: Neonatal Hypernatremia and Hypernatremic Dehydration in Neonates Receiving Exclusive Breastfeeding

    PubMed Central

    Mujawar, Nilofer Salim; Jaiswal, Archana Nirmal

    2017-01-01

    Aims and Objectives: Evaluation of neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding. Introduction: Neonatal hypernatremia is a serious condition in the newborn period. We present infants with hypernatremic dehydration due to breast milk (BM) hypernatremia. Hypernatremic dehydration in breast-fed newborns is usually secondary to insufficient lactation. We present the neonatal hypernatremia and hypernatremic dehydration encountered between January and December, 2012, its causes and treatment. Methodology: This was a retrospective study. We analyzed records of babies admitted to the Neonatal Intensive Care Unit who were investigated and found to have hypernatremia and whose mother's BM sodium (BM Na) was done. Inclusion Criteria: (1) Babies with serum Na >145 meq/l, (2) euglycemia, (3) normocalcemic, (4) no clinical and lab evidence of sepsis, (5) exclusive breast feeds. Exclusion Criteria: Neonates not satisfying any mentioned criterion. Results: BM Na correlated strongly with neonatal hypernatremia in exclusively breast-fed babies who did not otherwise have any risk factor. Conclusion: Elevated BM Na is an important etiological factor in neonatal hypernatremia. PMID:28197048

  10. Microbial Experiments on Basal Ice from John Evans Glacier, Eastern Ellesmere Island, Northwest Territories, Canada

    NASA Astrophysics Data System (ADS)

    Skidmore, M.; Foght, J.; Sharp. M.

    1998-01-01

    Recent research on permanent-ice associated microorganisms has focused on surficial ice environments. We present evidence that, to the authors' knowledge, is the first example that aerobic and anaerobic bacteria can be cultured at 4C from sediment-rich basal ice from a large polythermal Arctic glacier (John Evans Glacier). This builds on previous work in which we demonstrated that both aerobic and anaerobic microbes exist in viable populations in subglacial meltwaters at the same glacier, and that the populations increase with sediment concentration. This high Arctic glacier (at 80N) may be a reasonable terrestrial analog for martian polar environments, and hence the findings of this study may be important in assisting sampling program development for microbiology in the martian polar regions. Sterile samples of both debris-rich basal ice and debris-poor (clean) glacier ice were taken aseptically from the glacier margin in the spring of 1997 prior to the onset of the melt season to examine whether any observed microbial activity was linked to sediment concentration. The samples were melted slowly in a sterile environment and then incubated at 4C under nutrient-amended and nutrient-unamended conditions for three months. Parallel sterile and poisoned controls were included to account for abiotic processes. In all cases microbiological activity was recorded in the sediment-rich samples amended with growth medium. This indicates that viable anaerobic and aerobic bacteria were present in the debris-rich basal ice. The dissolved organic C (DOC) concentrations and sigma-13-C DOC of unamended ice samples were also analyzed. DOC concentrations in the basal ice were 4x higher than in the clean ice. Furthermore, the sigma-13-C values of the DOC suggested different sources for the DOC in the two types of ice. The higher DOC values in the unamended basal ice samples suggest that there is in situ microbial activity in the subglacial sediments. This is supported by the presence

  11. Renal endothelin system and excretory function in Wistar-Kyoto and Long-Evans rats.

    PubMed

    Girchev, R; Bäcker, A; Markova, P; Kramer, H J

    2006-01-01

    The role of the kidney endothelin system in the renal regulation of fluid and electrolyte excretion was investigated in Wistar-Kyoto (WKY) and Long-Evans (LE) rats in which we found previously marked differences in the renal excretory responses to endothelin A receptor blockade. The selective endothelin A and B receptor antagonists BQ-123 (16.4 nmol kg(-1) min(-1)) and BQ-788 (25 nmol kg(-1) min(-1)) were infused i.v. for 50 min in conscious chronically instrumented WKY and LE rats and their renal function and renal endothelin system were studied. Without effects on glomerular filtration rate or renal blood flow, BQ-123 and BQ-788 decreased by more than 50% (P < 0.01) both urine flow rate and electrolyte excretion in WKY rats but only urine flow rate (P < 0.05) in LE rats. Endothelin-1 content, preproET-1/GPDH mRNA ratio, B(max) and K(d) of total endothelin receptors in renal cortex did not differ between the two strains. In contrast, plasma endothelin-1 concentration (0.58 +/- 0.04 vs. 1.05 +/- 0.01 femtomol mL(-1); P < 0.01), renal papillary ET-1 concentration (68 +/- 5 vs. 478 +/- 62 fmol mg(-1) protein; P < 0.01) and preproET-1/GPDH mRNA ratio (0.65 +/- 0.09 vs. 0.88 +/- 0.05; P < 0.05) as well as total endothelin receptor number in renal papilla (B(max) 5.3 +/- 0.4 vs. and 9.0 +/- 1.2 pmol mg(-1) protein; P < 0.05) were markedly lower in LE than in WKY rats. In vitro studies showed that in both strains ET(B) receptors on renal cortical membranes amounted between 65% and 67% and on papillary membranes between 85% and 88%. The present data show that the selective ET(A) or ET(B) receptor blockade differentially affects tubular water and salt handling, which becomes apparent in conditions of low renal papillary endothelin receptor number and tissue endothelin-1 concentration.

  12. The effect of RMP-7 and its derivative on transporting Evans blue liposomes into the brain.

    PubMed

    Zhang, Xiaobin; Xie, Ying; Jin, Yiguang; Hou, Xinpu; Ye, Liya; Lou, Jinning

    2004-01-01

    To investigate the effect of RMP-7 and its derivative on drug transport across blood brain barrier (BBB), RMP-7 and DSPE-PEG-NHS [1,2-dioleoyl-sn-glycero-3-phosphoethanolamine-n-[poly(ethyleneglycol)]-hydroxy succinamide, PEG M 3400] were conjugated under mild conditions and the reaction ratio was determined using MALDI-TOF-MS (matrix-assisted laser desorption-ionization time-of-flight mass spectrometry). An endothelial cell monolayer in vitro BBB model was established and used to determine the bioactivity of RMP-7 and its derivative "opening BBB." Horse radish peroxide (HRP), liposome (HRP-L-PEG), and Evans blue (EB) liposome (EB-L-PEG) were prepared using the reverse-phase evaporation method. HRP-L-PEG-RMP-7 and EB-L-PEG-RMP-7 were obtained by inserting DSPE-PEG-RMP-7 into the surface of liposome. The bioactivity of RMP-7 and DSPE-PEG-RMP-7 opening BBB were evaluated to determine their effect on the permeation ratio of HRP and HRP liposome across the in vitro BBB model. To evaluate the in vivo bioactivity of RMP-7 and DSPE-PEG-RMP-7 on EB transport across BBB into the brain, the indicated compounds were administered to rats. Then, brain slices were analyzed using confocal laser scanning microcopy and the EB concentration in the brain, liver, spleen, lung, and kidney was determined using the formamide-extraction-ultraviolet-spectrophotometric method. The results demonstrated that RMP-7 was conjugated with DSPE-PEG-NHS at the molecular ratio of 1:1 and the product is DSPE-PEG-RMP-7. Compared with adding HRP alone, RMP-7 and DSPE-PEG-RMP-7 improved 2- to 3-fold the transport of HRP in the in vitro BBB model. The in vivo experiments showed that DSPE-PEG-RMP-7 was better at facilitating EB transport into brain than RMP-7. The reason may be that DSPE-PEG-RMP-7 can "open BBB" as soon as the EB-L-PEG-RMP-7 reaches BBB.

  13. Lymphatic mapping with 99mTc-Evans Blue dye in sheep.

    PubMed

    Tsopelas, Chris; Bellon, Max; Bevington, Elaine; Kollias, James; Shibli, Sabah; Chatterton, Barry E

    2008-11-01

    99mTc-Evans Blue (EB) is an agent that contains both radioactive and color signals in a single dose. Earlier studies in animal models have suggested that this agent when compared with the dual-injection technique of radiocolloid/blue dye can successfully discriminate the sentinel lymph node. The aim of this study was to investigate the potential of 99mTc-EB as an agent to map the lymphatic system in an ovine model. Doses of 99mTc-EB (23 MBq) containing EB dye (4 mg) were administered intradermally to the limbs of four anesthetized sheep, and they were then imaged over 20-30 min using a gamma camera. The study protocol was repeated using 99mTc-antimony trisulfide colloid (ATC) and Patent Blue V dye. The lymph nodes (popliteal, inguinal, and iliac for hind limbs or prescapular for fore limbs) were identified with a gamma probe during the operative exposure, then dissected and counted in a large volume counter. Simple and complex (dual) drainage patterns were visible on the scans, and the sentinel node was more radioactive than higher tier nodes in a chain, for both radiotracers. For 99mTc-EB, maximum radioactive uptake was achieved at 3-6 min for popliteal lymph nodes, 12-14 min for iliac nodes, and 13-14 min for prescapular nodes. 99mTc-ATC resulted in maximum radioactive uptake at 4-6 min for popliteal lymph nodes, 13 min for an inguinal node, 13-20 min for iliac nodes, and 18 min for a prescapular node. Following 99mTc-EB injection, 15/15 lymph nodes harvested were all radioactive and blue. For 99mTc-radiocolloid/Patent Blue V injection, 8/14 nodes were radioactive and blue, and 6/14 nodes were radioactive only. The soluble radiotracer 99mTc-EB appeared to be a useful lymphoscintigraphic agent in sheep, in which radioactive counts from superficial lymphatic channels and lymph nodes were sufficient for planar imaging. In comparison with 99mTc-antimony trisulfide colloid, both tracers discriminated the sentinel lymph node up to 50 min after administration; however

  14. Plasma volume by Evans blue: effects of eating and comparison with other methods at altitude.

    PubMed

    Loeppky, Jack A; Luther, Deborah K; Maes, Damon; Riboni, Katrina; Hinghofer-Szalkay, Helmut; Charlton, Gerald A; Icenogle, Milton V

    2002-09-01

    Measurements of plasma volume (PV) and its changes (delta%PV) by Evans blue (EB) dye are presumed to be valid only in fasting subjects. In addition, delta%PVEB with acute altitude exposure has not been compared with other methods employing the concentration or dilution of naturally occurring blood (hematocrit (Hct), hemoglobin (Hb)) and plasma (density, proteins) components, but should be similar if capillary permeability and the sampled vein/whole body Hct ratio remain unchanged. PVEB was determined in six subjects while fasting or eating on different days, with injection and sampling in the same arm, 4-h extrapolation to time zero and correcting readings with the 620-740 A method. For 93 experiments at altitude, delta%PVEB was obtained similarly from a 3-h extrapolation near the end of a 12-h chamber exposure to 426 mm Hg (-4,880 m =16,000 ft) and at the same time on the preceding control day. Mean PVEB with and without eating was not significantly different (SE of absolute difference = +/- 2.8%). The EB decay curves had significantly more scatter with eating than fasting. The fasting vs. non-fasting values for the single 20-min post-injection point also gave a close comparison (r = +0.97). At altitude the loss in PV measured with EB was significantly greater (delta%PVEB = -6.3%) than losses estimated from Hct-Hb (-2.9%), plasma protein (-3.7%), and plasma density (-3.9%). The expected larger PV loss in subjects tolerant to altitude sickness compared with intolerant ones was most clearly shown by delta%PVEB (8.8%). Obtaining more samples can offset reproducibility lost by eating. The delta%PVEB were largest and nearest to values previously reported at altitude, perhaps because the single baseline and altitude samples utilized by the other methods are more sensitive to subtle, transient fluctuations in body water and vasomotor tone associated with apprehension, vomiting, fluid intake, and regional vasodilation and constriction.

  15. Ethanol Seeking by Long Evans Rats Is Not Always a Goal-Directed Behavior

    PubMed Central

    Mangieri, Regina A.; Cofresí, Roberto U.; Gonzales, Rueben A.

    2012-01-01

    Background Two parallel and interacting processes are said to underlie animal behavior, whereby learning and performance of a behavior is at first via conscious and deliberate (goal-directed) processes, but after initial acquisition, the behavior can become automatic and stimulus-elicited (habitual). With respect to instrumental behaviors, animal learning studies suggest that the duration of training and the action-outcome contingency are two factors involved in the emergence of habitual seeking of “natural” reinforcers (e.g., sweet solutions, food or sucrose pellets). To rigorously test whether behaviors reinforced by abused substances such as ethanol, in particular, similarly become habitual was the primary aim of this study. Methodology/Principal Findings Male Long Evans rats underwent extended or limited operant lever press training with 10% sucrose/10% ethanol (10S10E) reinforcement (variable interval (VI) or (VR) ratio schedule of reinforcement), or with 10% sucrose (10S) reinforcement (VI schedule only). Once training and pretesting were complete, the impact of outcome devaluation on operant behavior was evaluated after lithium chloride injections were paired with the reinforcer, or unpaired 24 hours later. After limited, but not extended instrumental training, lever pressing by groups trained under VR with 10S10E and under VI with 10S was sensitive to outcome devaluation. In contrast, responding by both the extended and limited training 10S10E VI groups was not sensitive to ethanol devaluation during the test for habitual behavior. Conclusions/Significance Operant behavior by rats trained to self-administer an ethanol-sucrose solution showed variable sensitivity to a change in the value of ethanol, with relative insensitivity developing sooner in animals that received time-variable ethanol reinforcement during training sessions. One important implication, with respect to substance abuse in humans, is that initial learning about the relationship between

  16. Oxygen consumption and distribution in the Long-Evans rat retina

    PubMed Central

    Lau, Jennifer C.M.; Linsenmeier, Robert A.

    2012-01-01

    The purpose of this study was to investigate the oxygen distribution and consumption in the pigmented Long-Evans rat retina in vivo during dark and light adaptation, and to compare these results to previous work on cat and albino rat. Double-barreled microelectrodes recorded both intraretinal PO2 depth profiles and the electroretinogram (ERG), which was used to identify the boundaries of the retina. Light adaptation decreased photoreceptor oxygen consumption per unit volume (Qav) from 3.0±0.4 ml•100 g−1•min−1 (mean ± SEM) in darkness to 1.8±0.2 ml•100 g−1•min−1 and increased minimum outer retinal PO2 at the inner segments (Pmin) from 17.4±3.0 to 29.9±5.3 mmHg. The effects of light on outer retinal PO2 and Qav were similar to those previously observed in cat, monkey, and albino rats; however, dark-adapted Pmin was higher in rat than cat. The parameters derived from fitting the oxygen diffusion model to the rat data were compared to those from cat. Oxygen consumption of the inner segments (Q2) and choroidal PO2 (PC) in rat and cat were similar. Pmin was higher in rat than in cat for two reasons: first, rat photoreceptors have a shorter oxygen consuming region; and second, the retinal circulation supplied a greater fraction of consumed oxygen to rat photoreceptors. The average PO2 across the inner retina (PIR) was not different in dark adaptation (25.4±4.8 mm Hg) and light adaptation (28.8±5.4 mmHg) when measured from PO2 profiles. However, with the microelectrode stationary at 9–18% retinal depth, a small consistent decrease in PO2 occurred during illumination. Flickering light at 6 Hz decreased inner retinal PO2 significantly more than an equivalent steady illumination, suggesting that changes in blood flow did not completely compensate for increased metabolism. This study comprehensively characterized rat retinal oxygenation in both light and dark, and determined the similarities and differences between rat and cat retinas. PMID:22828049

  17. An efficient shooting algorithm for Evans function calculations in large systems

    NASA Astrophysics Data System (ADS)

    Humpherys, Jeffrey; Zumbrun, Kevin

    2006-08-01

    In Evans function computations of the spectra of asymptotically constant-coefficient linear operators, a basic issue is the efficient and numerically stable computation of subspaces evolving according to the associated eigenvalue ODE. For small systems, a fast, shooting algorithm may be obtained by representing subspaces as single exterior products [J.C. Alexander, R. Sachs, Linear instability of solitary waves of a Boussinesq-type equation: A computer assisted computation, Nonlinear World 2 (4) (1995) 471-507; L.Q. Brin, Numerical testing of the stability of viscous shock waves, Ph.D. Thesis, Indiana University, Bloomington, 1998; L.Q. Brin, Numerical testing of the stability of viscous shock waves, Math. Comp. 70 (235) (2001) 1071-1088; L.Q. Brin, K. Zumbrun, Analytically varying eigenvectors and the stability of viscous shock waves, in: Seventh Workshop on Partial Differential Equations, Part I, 2001, Rio de Janeiro, Mat. Contemp. 22 (2002) 19-32; T.J. Bridges, G. Derks, G. Gottwald, Stability and instability of solitary waves of the fifth-order KdV equation: A numerical framework, Physica D 172 (1-4) (2002) 190-216]. For large systems, however, the dimension of the exterior-product space quickly becomes prohibitive, growing as (n/k), where n is the dimension of the system written as a first-order ODE and k (typically ˜n/2) is the dimension of the subspace. We resolve this difficulty by the introduction of a simple polar coordinate algorithm representing “pure” (monomial) products as scalar multiples of orthonormal bases, for which the angular equation is a numerically optimized version of the continuous orthogonalization method of Drury-Davey [A. Davey, An automatic orthonormalization method for solving stiff boundary value problems, J. Comput. Phys. 51 (2) (1983) 343-356; L.O. Drury, Numerical solution of Orr-Sommerfeld-type equations, J. Comput. Phys. 37 (1) (1980) 133-139] and the radial equation is evaluable by quadrature. Notably, the polar

  18. Chronic social instability increases anxiety-like behavior and ethanol preference in male Long Evans rats.

    PubMed

    Roeckner, Alyssa R; Bowling, Alexandra; Butler, Tracy R

    2017-02-13

    Chronic stress during adolescence is related to increased prevalence of anxiety disorders and alcohol use disorders in humans. This phenotype has been consistently recapitulated in animal models with male subjects, but models using female subjects are fewer. The aim of these studies was to test the hypothesis that chronic social instability (CSI) during adolescence engenders increased anxiety-like behavior, increased corticosterone, and greater ethanol intake and/or preference than control groups in male and female rats. A chronic social instability (CSI) procedure was conducted in separate cohorts of female and male adolescent Long Evans rats. CSI included daily social isolation for 1h, and then pair housing with a novel cage mate for 23h until the next 1h isolation period from PND 30-46. Control groups included social stability (SS), chronic isolation (ISO), and acute social instability (aSI). At PND 49-50, anxiety-like behavior was assessed on the elevated plus maze, and on PND 51 tails bloods were obtained for determination of corticosterone (CORT) levels. This was followed by 4weeks of ethanol drinking in a home cage intermittent access ethanol drinking paradigm (PND 55-81 for males, PND 57-83 for females). Planned contrast testing showed that the male CSI group had greater anxiety-like behavior compared controls, but group differences were not apparent for CORT. CSI males had significantly higher levels of ethanol preference during drinking weeks 2-3 compared to all other groups and compared to SS and ISO groups in week 4. For the female cohort, we did not observe consistent group differences in anxiety-like behavior, CORT levels were unexpectedly lower in the ISO group only compared to the other groups, and group differences were not apparent for ethanol intake/preference. In conclusion, chronic stress during adolescence in the form of social instability increases anxiety-like behavior and ethanol preference in male rats, consistent with other models of

  19. Cardiovascular Ultrasound of Neonatal Long Evans Rats Exposed Prenatally to Trichloroacetic Acid: Effects on Heart Rate, Ejection Fraction, and Cardiac Output

    EPA Science Inventory

    This abstract describes the use of a relatively new technology, cardiovascular ultrasound (echocardiography) for evaluating developmental toxicity affecting heart development. The abstract describes the effects of two known cardiac teratogens, trichloroacetic acid and dimethadio...

  20. Participatory design methods for the development of a clinical telehealth service for neonatal homecare

    PubMed Central

    Garne Holm, Kristina; Brødsgaard, Anne; Zachariassen, Gitte; Smith, Anthony C.; Clemensen, Jane

    2017-01-01

    Objectives: Neonatal homecare delivered during home visits by neonatal nurses is a common method for supporting families of preterm infants following discharge. Telehealth has been introduced for the provision of neonatal homecare, resulting in positive feedback from parents of preterm infants. While the benefits are beginning to be realised, widespread uptake of telehealth has been limited due to a range of logistical challenges. Understanding user requirements is important when planning and developing a clinical telehealth service. We therefore used participatory design to develop a clinical telehealth service for neonatal homecare. Methods: The study adopted a participatory design approach to engage users in the development and design of a new telehealth service. Participatory design embraces qualitative research methods. Creative and technical workshops were conducted as part of the study. Tests of the telehealth service were conducted in the neonatal unit. Participants in this study were former and current parents of preterm infants eligible for neonatal homecare, and clinical staff (medical and nursing) from the neonatal unit. Preterm infants accompanied their parents. Results: Based on the results obtained during the workshops and subsequent testing, we developed an application (app), which was integrated into the medical record at the neonatal unit. The app was used to initiate videoconferences and chat messages between the family at home and the neonatal unit, and to share information regarding infant growth and well-being. Conclusion: Results obtained from the workshops and testing demonstrated the importance of involving users when developing new telehealth applications. The workshops helped identify the challenges associated with delivery of the service, and helped instruct the design of a new telehealth service for neonatal homecare based on the needs of parents and clinical staff. PMID:28975028

  1. Changes in plasma glucose in Otsuka Long-Evans Tokushima Fatty rats after oral administration of maple syrup.

    PubMed

    Nagai, Noriaki; Yamamoto, Tetsushi; Tanabe, Wataru; Ito, Yoshimasa; Kurabuchi, Satoshi; Mitamura, Kuniko; Taga, Atsushi

    2015-01-01

    We investigate whether maple syrup is a suitable sweetener in the management of type 2 diabetes using the Otsuka Long-Evans Tokushima Fatty (OLETF) rat. The enhancement in plasma glucose (PG) and glucose absorption in the small intestine were lower after the oral administration of maple syrup than after sucrose administration in OLETF rats, and no significant differences were observed in insulin levels. These data suggested that maple syrup might inhibit the absorption of glucose from the small intestine and preventing the enhancement of PG in OLETF rats. Therefore, maple syrup might help in the prevention of type 2 diabetes.

  2. Procuring gametes for research and therapy: the argument for unisex altruism--a response to Donald Evans.

    PubMed

    Dickenson, D L

    1997-04-01

    There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes.

  3. Evans syndrome and antibody deficiency: an atypical presentation of chromosome 22q11.2 deletion syndrome

    PubMed Central

    Colarusso, Gloria; Gambineri, Eleonora; Lapi, Elisabetta; Casini, Tommaso; Tucci, Fabio; Lippi, Francesca; Azzari, Chiara

    2010-01-01

    We report a case of an 8-year-old male patient with Evans syndrome and severe hypogammaglobulinemia, subsequently in whom the 22q11.2 deletion syndrome (22q11.2 DS) was diagnosed. No other clinical sign of 22q11.2 DS was present with the exception of slight facial dysmorphism. The case is of particular interest because it suggests the need to research chromosome 22q11.2 deletion in patients who present with autoimmune cytopenia and peculiar facial abnormalities, which could be an atypical presentation of an incomplete form of 22q11.2 DS. PMID:21589826

  4. Evans syndrome and antibody deficiency: an atypical presentation of chromosome 22q11.2 deletion syndrome.

    PubMed

    Colarusso, Gloria; Gambineri, Eleonora; Lapi, Elisabetta; Casini, Tommaso; Tucci, Fabio; Lippi, Francesca; Azzari, Chiara

    2010-09-06

    We report a case of an 8-year-old male patient with Evans syndrome and severe hypogammaglobulinemia, subsequently in whom the 22q11.2 deletion syndrome (22q11.2 DS) was diagnosed. No other clinical sign of 22q11.2 DS was present with the exception of slight facial dysmorphism. The case is of particular interest because it suggests the need to research chromosome 22q11.2 deletion in patients who present with autoimmune cytopenia and peculiar facial abnormalities, which could be an atypical presentation of an incomplete form of 22q11.2 DS.

  5. Cholinergic neurons in the caudate-putamen complex proper are intrinsically organized: a combined Evans blue and acetylcholinesterase analysis.

    PubMed

    Woolf, N J; Butcher, L L

    1981-11-01

    In an attempt to determine whether or not acetylcholinesterase (AChE)-containing neurons of the caudate-putamen proper were the source of striatal efferent fibers, we infused Evans Blue, a retrogradely transported fluorescent label, into the globus pallidus, entopeduncular nucleus, substantia nigra, or retrorubral area. Following microscopic analysis of the striatum for Evans Blue-labelled somata, the same brain sections were processed for AChE according to the pharmacohistochemical regimen and, after additional microscopic evaluation, were counterstained with cresyl violet. Histology for Nissl substance revealed that the areal density of cell bodies in the caudate-putamen complex proper was about 1510 somata/mm2. Striatal neurons labelled with Evans Blue, those considered to be projection cells, were medium-sized (approximate minor and major dimensions: 11 X 14 microns), had a density of roughly 833 cells/mm2, and were predominantly oval with lesser proportions being fusiform, triangular, or round. Each of the target structures received input from approximately 55% (range = 26-78%) of the total population of striatal neurons in regions where the projection cellsions: 11 X 14 microns), had a density of roughly 833 cells/mm2, and were predominantly oval with lesser proportions being fusiform, triangular, or round. Each of the target structures received input from approximately 55% (range = 26-78%) of the total population of striatal neurons in regions where the projection cellsions: 11 X 14 microns), had a density of roughly 833 cells/mm2, and were predominantly oval with lesser proportions being fusiform, triangular, or round. Each of the target structures received input from approximately 55% (range = 26-78%) of the total population of striatal neurons in regions where the projection cells were located. The two types of AChE-containing somata in the caudate-putamen complex proper--the medium-sized, lightly staining Type A and the large, intensely staining Type B

  6. Repeated plasma volume determination with the Evans Blue dye dilution technique: the method and a computer program.

    PubMed

    Foldager, N; Blomqvist, C G

    1991-01-01

    This paper describes a reliable multiple sample Evans Blue dye dilution technique and a Pascal program which computes plasma and blood volume on the basis of this technique. The program performs needed corrections and dye disappearance curve fitting. It provides menu-driven facilities for data correction, graphic display of the dye disappearance curve, and print-out of all the involved data. Means +/- S.E.M. for three plasma volume determinations in each of six resting subjects were: 3239 +/- 96 ml, 3189 +/- 81 ml, and 3187 +/- 102 ml. The differences were not statistically significant.

  7. Neonatal Conjunctivitis Leading to Neonatal Sepsis--A Case Report.

    PubMed

    Dey, A C; Hossain, M I; Dey, S K; Mannan, M A; Shahidullah, M

    2016-01-01

    Neonatal conjunctivitis is the most common occular disease in neonates. Most infections are acquired during vaginal delivery. In spite most of these cases are benign; some of them may progress to systemic complications like loss of vision if left untreated. The authors present a case of a newborn who developed late onset neonatal sepsis from E. coli positive conjunctivitis. The baby was treated with Injection Meropenem and Injection Amikacin for 10 days. The course was uneventful, after that baby responded well and discharged home on 24th day.

  8. A model program: neonatal nurse practitioners providing community health care for high-risk infants.

    PubMed

    Vasquez, Elias Provencio; Pitts, Kathleen; Mejia, Nilson Enrique

    2008-01-01

    Perinatal drug exposure costs our communities millions of dollars each year in hospital fees and in services such as foster care, child protection, and drug treatment. Infants and their families in this group require substantial long-term health care and community resources. Neonatal health care providers should take an active role in developing and implementing home visitation programs to support early hospital discharge and continuity of care for these high-risk infants and their families. Neonatal nurse practitioners should prepare in the future to practice not only in secondary-- and tertiary--level neonatal centers, but also in follow-up clinics, long-term developmental centers, and the community This article describes a home intervention program delivered by neonatal nurse practitioners for high-risk infants and their mothers. The target population is infants exposed prenatally to drugs and/or alcohol.

  9. Rural Families and Early Intervention.

    ERIC Educational Resources Information Center

    Haring, Kathryn A.; Lovett, David L.

    This paper presents findings from a 5-year research project involving 50 primarily rural families with infants identified neonatally in birth crisis, or shortly thereafter, as having developmental disabilities. Parents were interviewed to gather information on their perceptions of and experiences with the early intervention (EI) process.…

  10. Comprehensive Behavioural Analysis of Long Evans and Sprague-Dawley Rats Reveals Differential Effects of Housing Conditions on Tests Relevant to Neuropsychiatric Disorders

    PubMed Central

    Turner, Karly M.; Burne, Thomas H. J.

    2014-01-01

    Genetic (G) and environmental (E) manipulations are known to alter behavioural outcomes in rodents, however many animal models of neuropsychiatric disorders only use a restricted selection of strain and housing conditions. The aim of this study was to examine GxE interactions comparing two outbred rat strains, which were housed in either standard or enriched cages. The strains selected were the albino Sprague-Dawley rat, commonly used for animal models, and the other was the pigmented Long Evans rat, which is frequently used in cognitive studies. Rats were assessed using a comprehensive behavioural test battery and included well-established tests frequently employed to examine animal models of neuropsychiatric diseases, measuring aspects of anxiety, exploration, sensorimotor gating and cognition. Selective strain and housing effects were observed on a number of tests. These included increased locomotion and reduced pre-pulse inhibition in Long Evans rats compared to Sprague Dawley rats; and rats housed in enriched cages had reduced anxiety-like behaviour compared to standard housed rats. Long Evans rats required fewer sessions than Sprague Dawley rats to learn operant tasks, including a signal detection task and reversal learning. Furthermore, Long Evans rats housed in enriched cages acquired simple operant tasks faster than standard housed Long Evans rats. Cognitive phenotypes in animal models of neuropsychiatric disorders would benefit from using strain and housing conditions where there is greater potential for both enhancement and deficits in performance. PMID:24671152

  11. Neonates and Infants Discharged Home Dependent on Medical Technology: Characteristics and Outcomes.

    PubMed

    Toly, Valerie Boebel; Musil, Carol M; Bieda, Amy; Barnett, Kimberly; Dowling, Donna A; Sattar, Abdus

    2016-10-01

    Preterm neonates and neonates with complex conditions admitted to a neonatal intensive care unit (NICU) may require medical technology (eg, supplemental oxygen, feeding tubes) for their continued survival at hospital discharge. Medical technology introduces another layer of complexity for parents, including specialized education about neonatal assessment and operation of technology. The transition home presents a challenge for parents and has been linked with greater healthcare utilization. To determine incidence, characteristics, and healthcare utilization outcomes (emergency room visits, rehospitalizations) of technology-dependent neonates and infants following initial discharge from the hospital. This descriptive, correlational study used retrospective medical record review to examine technology-dependent neonates (N = 71) upon discharge home. Study variables included demographic characteristics, hospital length of stay, and type of medical technology used. Analysis of neonates (n = 22) with 1-year postdischarge data was conducted to identify relationships with healthcare utilization. Descriptive and regression analyses were performed. Approximately 40% of the technology-dependent neonates were between 23 and 26 weeks' gestation, with birth weight of less than 1000 g. Technologies used most frequently were supplemental oxygen (66%) and feeding tubes (46.5%). The mean total hospital length of stay for technology-dependent versus nontechnology-dependent neonates was 108.6 and 25.7 days, respectively. Technology-dependent neonates who were female, with a gastrostomy tube, or with longer initial hospital length of stay were at greater risk for rehospitalization. Assessment and support of families, particularly mothers of technology-dependent neonates following initial hospital discharge, are vital. Longitudinal studies to determine factors affecting long-term outcomes of technology-dependent infants are needed.

  12. Oxidative stress in the neonate.

    PubMed

    Robles, R; Palomino, N; Robles, A

    2001-11-01

    The aim of this study is to determine the oxidative state of term and preterm neonates at the moment of birth and during the first days of life, and the influence of exposure to oxygen on the premature neonates.A total of 20 neonates were selected. Group A: 10 healthy full-term neonates, and Group B: 10 preterm neonates with no other pathology associated, requiring oxygen therapy. Venous samples were taken in cord at 3 and 72 h in Group A, and in cord at 3, 24 and 72 h and 7 days in Group B.Hydroperoxides, Q10 coenzyme (Co Q10) and alpha-tocopherol were measured within the erythrocyte membrane. Levels of hydroperoxides present in erythrocyte membrane were higher than normal both in Group A and in Group B at birth. This increase was greater in the group of premature neonates. Levels of alpha-tocopherol at birth increase significantly at 72 h in term neonates. Among the premature newborns, alpha-tocopherol levels are two to three times lower at birth and do not rise to higher levels as in the term neonate group. Fall in levels of Co Q10 in erythrocyte membranes is observed, and perhaps is due to the role of Co Q10 in maintaining the pool of reduced tocopherol. At birth, the neonate presents an increase of markers of oxidative stress and a decrease of their antioxidant defenses. This difference is greater as gestational age decreases. The application of oxygen therapy resulted in these levels which remain low throughout the study period.

  13. [The role of neonatal nursing in palliative care of the newborn].

    PubMed

    Herranz-Rubia, Nuria

    2007-01-01

    Nursing dying newborns is an inherent part of working in a neonatal intensive care (NICU). Holistic care involves recognizing the physical, emotional and spiritual needs of the dying infant and the family. The present article aims to explore how nurses can provide the best practices in neonatal palliative care. Palliative care is composed of three components: assistance with end-of-life decision making; pain and comfort management, and bereavement support with cultural competence. These issues have implications for improving nursing practice.

  14. Continuous electroencephalography monitoring in neonates.

    PubMed

    Shellhaas, Renée A

    2012-08-01

    As more critically ill term and premature neonates are surviving their acute illness, their long-term neurodevelopmental morbidity is being recognized. Continuous monitoring of cerebral function, with electroencephalography or derived digital trends, can provide key information regarding seizures and background patterns, with direct treatment and prognostic implications. Conventional video-electroencephalography remains the gold standard for neonatal seizure diagnosis and quantification, but can be supplemented by digital trending modalities. Both conventional and amplitude-integrated electroencephalography can provide valuable data regarding the background trends. This review describes indications and methods for continuous electroencephalography monitoring in high-risk neonates.

  15. Abdominal surgery in neonatal foals.

    PubMed

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  16. Neonatal herpes simplex virus infection.

    PubMed

    Cherpes, Thomas L; Matthews, Dean B; Maryak, Samantha A

    2012-12-01

    Neonatal herpes, seen roughly in 1 of 3000 live births in the United States, is the most serious manifestation of herpes simplex virus (HSV) infection in the perinatal period. Although acyclovir therapy decreases infant mortality associated with perinatal HSV transmission, development of permanent neurological disabilities is not uncommon. Mother-to-neonate HSV transmission is most efficient when maternal genital tract HSV infection is acquired proximate to the time of delivery, signifying that neonatal herpes prevention strategies need to focus on decreasing the incidence of maternal infection during pregnancy and more precisely identifying infants most likely to benefit from prophylactic antiviral therapy.

  17. [Courses in neonatal cardiopulmonary resuscitation].

    PubMed

    2003-03-01

    The optimal management of newborns with asphyxia is closely associated with improved survival and a better quality of life without neuromotor handicaps. Therefore, the training of health professionals who are present at the time of birth in neonatal resuscitation should be a priority. In the present article, we present a program of training courses in neonatal resuscitation. This program has been designed for the training of health care providers and instructors in technical aspects of neonatal resuscitation. The type of courses, their contents and methodology are described.

  18. Management and outcomes of neonates with down syndrome admitted to neonatal units.

    PubMed

    Mann, Jake P; Statnikov, Eugene; Modi, Neena; Johnson, Nik; Springett, Anna; Morris, Joan K

    2016-06-01

    Neonates with Down syndrome have an increased risk of being admitted to a neonatal unit compared with unaffected neonates. We aimed to estimate the proportion of neonates with Down syndrome admitted to a neonatal unit and compare their management and outcomes with other neonatal admissions. Case-control study of neonates born from 2009 to 2011 admitted to 122 NHS Neonatal Units in England using data from the National Down Syndrome Cytogenetic Register and the National Neonatal Research Database. For each neonate with Down syndrome, three neonates admitted to the same unit in the same month and born at the same gestation were identified. Forty-six percent of neonates with Down syndrome were admitted to a neonatal unit. Boys were more likely to be admitted than girls (odds ratio = 1.7; 95% confidence interval, 1.4-2.0). Neonates with Down syndrome required more intensive or high dependency care compared with unaffected neonates (37% vs. 27%. p < 0.01) and stayed in neonatal units for longer (11 days vs. 5 days, p < 0.01). A total of 31% of neonates with Down syndrome required respiratory support compared with 22% (p < 0.001) of unaffected neonates, and 11% were discharged requiring oxygen supplementation compared with 3% (p < 0.001) of unaffected neonates. A total of 3% of neonates with Down syndrome died in a neonatal unit compared with 1% (p = 0.01) of unaffected neonates. Neonates with Down syndrome are more likely than unaffected neonates to be admitted to a neonatal unit, have a prolonged stay, and be discharged home on supplemental oxygen. Birth Defects Research (Part A) 106:468-474, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Natal and neonatal teeth.

    PubMed

    Seminario, Ana Lucía; Ivancaková, Romana

    2004-01-01

    Tooth eruption follows a chronology corresponding to the date when the tooth erupts into the oral cavity. This date has been established in the literature and is subject to small variations depending on hereditary, endocrine and environmental features. Any disturbance during the development of the teeth -systemic or local- can affect not only the morphology, structure of dental hard tissues or number of teeth but also the time of eruption. The presence of a tooth in the mouth at birth or during the first month of life has been studied and denominated as natal and neonatal teeth. The aim of this paper is to review current information on this topic and to give treatment alternatives if it is necessary.

  20. [Neonatal lupus syndrome].

    PubMed

    Iwamoto, Masahiro

    2005-02-01

    Neonatal lupus syndrome is a passively acquired autoimmune syndrome in which pathogenic autoantibodies (anti-SSA/Ro, anti-SSB/La, and both, or rarely anti-U(1)RNP antibodies) are transmitted from a mother to her fetus through the placenta. The major clinical manifestations in the infants are cardiac (congenital heart block), dermatologic (skin lesion), hepatic (elevated hepatic enzymes), and hematologic (cytopenia). Congenital complete heart block (CCHB) is irreversible, while noncardiac manifestations are transient, resolving by one-year-old of age without specific treatments. Two prospective studies show that the prevalence of CCHB in children from a woman previously known to have anti-SSA/Ro antibodies is approximately 2%. However, when the previous pregnancy is complicated by CCHB and skin lesion, the recurrence rates of these symptoms go much higher to 10.5% and 26%, respectively, in the subsequent pregnancy.

  1. Neonatal sensitization to latex.

    PubMed

    Worth, J

    2000-05-01

    Babies born in delivery rooms of hospitals are exposed to latex through skin and mucous membrane contact with prepowdered latex gloves worn by midwives and doctors, and through the inhalation of latex-bound starch powder in the air of the delivery room. This paper examines the hypothesis that they are at risk for latex sensitization, and that part of the sharp increase of childhood asthma, eczema and anaphylaxis in the past 30-40 years may be linked. These possibilities seem hitherto unsuspected. In over 700 papers on latex allergy no mention of neonatal exposure to latex has been found. Even obstetric papers discussing the risks for an atopic mother (atopy - a tendency to develop allergies) do not seem to anticipate any risk for the baby, who might also be atopic. Latex allergy is primarily regarded as an occupational hazard. This paper suggests that it is a hazard for every baby handled by latex gloves at birth. Copyright 2000 Harcourt Publishers Ltd.

  2. [Neonatal seizures management].

    PubMed

    Roubertie, A; Masson, F; de Villepin-Touzery, A; Suau, B; Barbanel, G; Rideau, A; Cambonie, G

    2011-07-01

    For several decades, experimental studies have sought to explain the biological causes of newborn seizures and to assess the anatomical and functional consequences. Laboratory studies have shown that prolonged or repeated seizures disturb central nervous system development and may predispose to later epilepsy or cognitive deficits. Although these findings have not been clinically demonstrated in humans, several observations suggest that neonatal seizures have a deleterious effect on the immature brain and generate long-term sequelae. No therapeutic trial, however, has directly demonstrated the benefits of treatment, underlining the need for controlled studies that integrate the advances in electroencephalographic monitoring and pharmacology of anticonvulsant drugs. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  3. Neonatal Diabetes Mellitus

    PubMed Central

    Aguilar-Bryan, Lydia; Bryan, Joseph

    2008-01-01

    An explosion of work over the last decade has produced insight into the multiple hereditary causes of a nonimmunological form of diabetes diagnosed most frequently within the first 6 months of life. These studies are providing increased understanding of genes involved in the entire chain of steps that control glucose homeostasis. Neonatal diabetes is now understood to arise from mutations in genes that play critical roles in the development of the pancreas, of β-cell apoptosis and insulin processing, as well as the regulation of insulin release. For the basic researcher, this work is providing novel tools to explore fundamental molecular and cellular processes. For the clinician, these studies underscore the need to identify the genetic cause underlying each case. It is increasingly clear that the prognosis, therapeutic approach, and genetic counseling a physician provides must be tailored to a specific gene in order to provide the best medical care. PMID:18436707

  4. Neonatal lupus syndromes.

    PubMed

    Buyon, J P; Rupel, A; Clancy, R M

    2004-01-01

    The neonatal lupus syndromes (NLS), while quite rare, carry significant mortality and morbidity in cases of cardiac manifestations. Although anti-SSA/Ro-SSB/La antibodies are detected in > 85% of mothers whose fetuses are identified with congenital heart block (CHB) in a structurally normal heart, when clinicians applied this testing to their pregnant patients, the risk for a woman with the candidate antibodies to have a child with CHB was at or below 1 in 50. While the precise pathogenic mechanism of antibody-mediated injury remains unknown, it is clear that the antibodies alone are insufficient to cause disease and fetal factors are likely contributory. In vivo and in vitro evidence supports a pathologic cascade involving apoptosis of cardiocytes, surface translocation of Ro and La antigens, binding of maternal autoantibodies, secretion of profibrosing factors (e.g., TGFbeta) from the scavenging macrophages and modulation of cardiac fibroblasts to a myofibroflast scarring phenotype. The spectrum of cardiac abnormalities continues to expand, with varying degrees of block identified in utero and reports of late onset cardiomyopathy (some of which display endocardial fibroelastosis). Moreover, there is now clear documentation that incomplete blocks (including those improving in utero with dexamethasone) can progress postnatally, despite the clearance of the maternal antibodies from the neonatal circulation. Better echocardiographic measurements which identify first degree block in utero may be the optimal means of approaching pregnant women at risk. Prophylactic therapies, including treatment with intravenous immunoglobulin, await larger trials. In order to achieve advances at both the bench and bedside, national research registries established in the US and Canada are critical.

  5. We favor formal models of heuristics rather than lists of loose dichotomies: a reply to Evans and Over

    PubMed Central

    Gigerenzer, Gerd

    2009-01-01

    In their comment on Marewski et al. (good judgments do not require complex cognition, 2009) Evans and Over (heuristic thinking and human intelligence: a commentary on Marewski, Gaissmaier and Gigerenzer, 2009) conjectured that heuristics can often lead to biases and are not error free. This is a most surprising critique. The computational models of heuristics we have tested allow for quantitative predictions of how many errors a given heuristic will make, and we and others have measured the amount of error by analysis, computer simulation, and experiment. This is clear progress over simply giving heuristics labels, such as availability, that do not allow for quantitative comparisons of errors. Evans and Over argue that the reason people rely on heuristics is the accuracy-effort trade-off. However, the comparison between heuristics and more effortful strategies, such as multiple regression, has shown that there are many situations in which a heuristic is more accurate with less effort. Finally, we do not see how the fast and frugal heuristics program could benefit from a dual-process framework unless the dual-process framework is made more precise. Instead, the dual-process framework could benefit if its two “black boxes” (Type 1 and Type 2 processes) were substituted by computational models of both heuristics and other processes. PMID:19784854

  6. Innervation mapping of the hind paw of the rat using Evans Blue extravasation, Optical Surface Mapping and CASAM.

    PubMed

    Kambiz, S; Baas, M; Duraku, L S; Kerver, A L; Koning, A H J; Walbeehm, E T; Ruigrok, T J H

    2014-05-30

    Although numerous studies investigate sensory regeneration and reinnervation of the hind paw of the rat after nerve damage, no comprehensive overview of its normal innervation is present in literature. The Evans Blue extravasation technique is a well-known technique to study patterns of skin innervation. This technique has been performed differently by various groups but was never used to study the entire skin innervation in rats' hind paw including all three branches of the sciatic nerve and the saphenous nerve in detail. In this paper, we have used the Evans Blue extravasation technique to chart the skin areas innervated by the sural, peroneal, tibial and/or saphenous nerves, which together innervate the entire hind paw of the rat, and use a new technique to analyze the distribution, overlap and variability of the results. The technique is based on analysis of whole hind paws using Optical Surface Mapping (OSM) in combination with the Computer Assisted Surgical Anatomy Mapping (CASAM) technology. While the plantar hind paw is mainly innervated by the tibial nerve, the dorsal hind paw is supplied by the sural, peroneal and the saphenous nerve. Although our results basically concur with the general nerve-specific innervation of the rat hind paw, they show considerable detail in their areas of overlap as well as in the amount of variability between animals. These results will be invaluable to study and evaluate patterns of innervation and reinnervation of intact and damaged nerve fibers. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Simultaneous determination of dopamine, ascorbic acid and uric acid at poly (Evans Blue) modified glassy carbon electrode.

    PubMed

    Lin, Liqing; Chen, Jinghua; Yao, Hong; Chen, Yuanzhong; Zheng, Yanjie; Lin, Xinhua

    2008-06-01

    A sensitive and selective electrochemical method for the determination of dopamine using an Evans Blue polymer film modified on glassy carbon electrode was developed. The Evans blue polymer film modified electrode shows excellent electrocatalytic activity toward the oxidation of dopamine in phosphate buffer solution (pH 4.5). The linear range of 1.0 x 10(-6)-3.0 x 10(-5) M and detection limit of 2.5 x 10(-7) M were observed in pH 4.5 phosphate buffer solutions. The interference studies showed that the modified electrode exhibits excellent selectivity in the presence of large excess of ascorbic acid and uric acid. The separation of the oxidation peak potentials for dopamine-ascorbic acid and dopamine-uric acid were about 182 mV and 180 mV, respectively. The differences are large enough to determine AA, DA and UA individually and simultaneously. This work provides a simple and easy approach to selectively detect dopamine in the presence of ascorbic acid and uric acid in physiological samples.

  8. Re-evaluation of Evans Blue dye as a marker of albumin clearance in murine models of acute lung injury.

    PubMed

    Moitra, Jaideep; Sammani, Saad; Garcia, Joe G N

    2007-10-01

    Quantifying the amount of albumin conjugated to Evans Blue dye (EBA) fluxing across organ-specific vascular barriers is a popular technique to measure endothelial monolayer integrity in rodent and murine models of human diseases. We have re-evaluated this technique with a specific focus of assessing the commonly used turbidity correction factors. These factors, originally developed and required in a spectrophotometric assay to quantify Evans Blue (EB) in human infant or dog serum, produced negative numbers when applied to murine models of acute lung injury. We next sought to determine tissue-specific correction factors for murine tissues and experimentally derived such factors, which allow estimation of the amount of EB in formamide extracts of murine tissues as positive numbers. Utilization of a best fit correction factor in a lipopolysaccharide (LPS)-induced murine model of acute lung injury resulted in significantly increased sensitivity and repeatability of the EB dye tissue extravasation assay. This factor may be of significant utility in animal models of inflammatory injury.

  9. Cellular resistance to Evans blue toxicity involves an up-regulation of a phosphate transporter implicated in vesicular glutamate storage.

    PubMed

    Israël, M; Tomasi, M; Bostel, S; Meunier, F M

    2001-08-01

    It has recently been suggested that the brain-specific Na+-dependent phosphate inorganic co-transporter (BNPI) is able to support glutamate transport and storage in synaptic vesicles. A procedure for measuring the vesicular pool of glutamate is described and was used to select cell lines according to their glutamate storage capacity. Two cell lines were selected: C6BU-1, with a large intracellular glutamate storage capacity, and NG108-15, devoid of it. Their contents in BNPI mRNA were compared by RT-PCR. We found that both cell lines had BNPI, but in addition C6BU-1 alone expresses the other isoform, DNPI. We also carried out a clonal selection of NG108-15 cells in the presence of the dye Evans blue, a competitive inhibitor of vesicular glutamate transport, very toxic for cells in culture. It was assumed that only those that sequester and eliminate the drug by overexpressing a vesicular glutamate transporter would survive. We found that the NG108-15 clones resistant to Evans blue had an increased storage capacity for glutamate. These cells also up-regulated the BNPI isoform of the phosphate transporter as shown by RT-PCR and northern blot.

  10. Effects of Moderate Alcohol Intake in the Bladder of the Otsuka Long Evans Tokushima Fatty Diabetic Rats.

    PubMed

    Bae, Woong Jin; Choi, Yong Sun; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung Hoo; Kim, Sae Woong; Hwang, Tae-Kon; Kim, Dai Jin; Lee, Ji Youl

    2015-09-01

    Diabetes is related with a number of cystopathic complications. However, there have been no studies about the influence of alcohol consumption in the bladder of type 2 diabetes. Thus, we investigated the effect of moderate alcohol intake in the bladder of the Otsuka Long Evans Tokushima Fatty (OLETF) diabetic rat. The non-diabetic Long-Evans Tokushima Otsuka (LETO, n=14) and the OLETF control group (n=14) were fed an isocaloric diet; the LETO (n=14) and the OLETF ethanol group (n=14) were fed 36% ethanol 7 g/kg/day. After ten weeks, muscarinic receptors, RhoGEFs, myogenic change, and the level of oxidative stress were evaluated. Moderate alcohol intake significantly decreased excessive muscarinic receptor and Rho kinase expressions in the OLETF rats compared with the LETO rats. In addition, iNOS and collagen expression were not changed in the OLETF rats in spite of alcohol consumption. Superoxide dismutase levels, which is involved in antioxidant defense, in the LETO rats were significantly decreased after alcohol consumption, however those in the OLETF rats were similar. Moderate alcohol consumption reduces the oxidative stress, and may prevent molecular and pathologic changes of the bladder of rats with type 2 diabetes.

  11. Low susceptibility to N-ethyl-N-nitrosourea-induced transplacental carcinogenesis in Long-Evans Cinnamon (LEC) rats.

    PubMed

    Tsuchigauchi, Takeshi; Takahashi, Tetsuyuki; Ohnishi, Takamasa; Ogawa, Hirohisa; Bando, Yoshimi; Uehara, Hisanori; Takizawa, Tamotsu; Kaneda, Shinya; Nakai, Tokiko; Shiota, Hiroshi; Izumi, Keisuke

    2009-08-01

    The Long-Evans Cinnamon (LEC) rat, an animal model of Wilson's disease, is resistant to a variety of chemical carcinogenesis except liver and colon. In the present study, N-ethyl-N-nitrosourea (ENU)-induced transplacental carcinogenesis was examined in male and female LEC, Long-Evans Agouti (LEA), a sibling line of the LEC rat, and F344 rats (n=21). ENU was administered to pregnant rats as a single s.c. injection at a dose of 60 mg/kg body weight on the 17th day after conception. Cerebral/spinal gliomas and trigeminal/spinal nerve schwannomas developed in both LEA and F344 rats at 30 weeks of age, but no nervous system tumors developed in LEC rats, the difference being statistically significant. Lung adenomas also developed in LEA and F344 rats, but not in LEC rats. Semiquantitative RT-PCR demonstrated that metallothionein (MT)1a, MT2 and O(6)-methylguanine-DNA methyltransferase (MGMT) mRNA levels in the liver of LEC rats were higher than those in F344 and LEA rats. In addition, Western blot analysis showed that MT (MT1 plus MT2) in the liver of LEC rats was also higher than that in other strains. Present results suggest that high levels of MT and/or MGMT contribute to the resistance to nitrosamine-induced carcinogenesis in LEC rats.

  12. Congenital isolated adrenocorticotropin deficiency: an underestimated cause of neonatal death, explained by TPIT gene mutations.

    PubMed

    Vallette-Kasic, Sophie; Brue, Thierry; Pulichino, Anne-Marie; Gueydan, Magali; Barlier, Anne; David, Michel; Nicolino, Marc; Malpuech, Georges; Déchelotte, Pierre; Deal, Cheri; Van Vliet, Guy; De Vroede, Monique; Riepe, Felix G; Partsch, Carl-Joachim; Sippell, Wolfgang G; Berberoglu, Merih; Atasay, Begüm; de Zegher, Francis; Beckers, Dominique; Kyllo, Jennifer; Donohoue, Patricia; Fassnacht, Martin; Hahner, Stefanie; Allolio, Bruno; Noordam, C; Dunkel, Leo; Hero, Matti; Pigeon, B; Weill, Jacques; Yigit, Sevket; Brauner, Raja; Heinrich, Juan Jorge; Cummings, Elizabeth; Riddell, Christie; Enjalbert, Alain; Drouin, Jacques

    2005-03-01

    Tpit is a T box transcription factor important for terminal differentiation of pituitary proopiomelanocortin-expressing cells. We demonstrated that human and mouse mutations of the TPIT gene cause a neonatal-onset form of congenital isolated ACTH deficiency (IAD). In the absence of glucocorticoid replacement, IAD can lead to neonatal death by acute adrenal insufficiency. This clinical entity was not previously well characterized because of the small number of published cases. Since identification of the first TPIT mutations, we have enlarged our series of neonatal IAD patients to 27 patients from 21 unrelated families. We found TPIT mutations in 17 of 27 patients. We identified 10 different TPIT mutations, with one mutation found in five unrelated families. All patients appeared to be homozygous or compound heterozygous for TPIT mutations, and their unaffected parents are heterozygous carriers, confirming a recessive mode of transmission. We compared the clinical and biological phenotype of the 17 IAD patients carrying a TPIT mutation with the 10 IAD patients with normal TPIT-coding sequences. This series of neonatal IAD patients revealed a highly homogeneous clinical presentation, suggesting that this disease may be an underestimated cause of neonatal death. Identification of TPIT gene mutations as the principal molecular cause of neonatal IAD permits prenatal diagnosis for families at risk for the purpose of early glucocorticoid replacement therapy.

  13. Serum immunoglobulins in Nigerian neonates.

    PubMed

    Akinwolere, O A; Akinkugbe, F M; Oyewole, A I; Salimonu, L S

    1989-01-01

    Serum immunoglobulins G, M and A levels were studied in 187 Nigerian neonates. Estimations were done by the radial immunodifusion method of Mancini. Immunoglobulin G shows a fall in value in the first few days of life to about 62% of the value in the last days of the neonatal period. There is however a gradual increase in the level of IgM to about double at the end of the neonatal period. IgA level remained relatively constantly low throughout this period. The effect of maternal education on the levels of immunoglobulins of their neonates was also investigated. This had a positive influence at the secondary educational level, affecting only the IgG and IgA.

  14. Therapeutic hypothermia in neonatal asphyxia

    PubMed Central

    Cornette, L.

    2012-01-01

    Hypoxic ischemic encephalopathy is a serious condition affecting newborn infants which can result in death and disability. There is now strong clinical evidence that moderate post-asphyxial total body cooling or hypothermia in full term neonates results in long-term neuroprotection, allowing us to proclaim this innovative therapy as “standard of care.” The treatment is a time-critical emergency and should be started within 6 hours after the insult. Such requires optimal collaboration among local hospitals, transport teams and the closest neonatal intensive care unit. The technique is only safe when applied according to published clinical trial protocols, and with admission of these patients to a neonatal intensive care unit. Future studies should be aimed at optimizing the onset, duration, and depth of hypothermia. Combination of hypothermia and drugs may further improve neuroprotection in asphyxiated full term neonates. PMID:24753900

  15. Neonatal euthanasia: The Groningen Protocol*

    PubMed Central

    Vizcarrondo, Felipe E.

    2014-01-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible. PMID:25473136

  16. Neonatal euthanasia: The Groningen Protocol.

    PubMed

    Vizcarrondo, Felipe E

    2014-11-01

    For the past thirty years, voluntary euthanasia and physician-assisted suicide of adult patients have been common practice in the Netherlands. Neonatal euthanasia was recently legalized in the Netherlands and the Groningen Protocol (GP) was developed to regulate the practice. Supporters claim compliance with the GP criteria makes neonatal euthanasia ethically permissible. An examination of the criteria used by the Protocol to justify the euthanasia of seriously ill neonates reveals the criteria are not based on firm moral principles. The taking of the life of a seriously ill person is not the solution to the pain and suffering of the dying process. It is the role of the medical professional to care for the ailing patient with love and compassion, always preserving the person's dignity. Neonatal euthanasia is not ethically permissible.

  17. 99mTc-Evans blue dye for mapping contiguous lymph node sequences and discriminating the sentinel lymph node in an ovine model.

    PubMed

    Tsopelas, Chris; Bevington, Elaine; Kollias, James; Shibli, Sabah; Farshid, Gelareh; Coventry, Brendon; Chatterton, Barry E

    2006-05-01

    The aim of this study was to investigate the potential of (99m)Tc-Evans blue for discriminating the sentinel lymph node in multitiered lymph node sequences by using an ovine model. (99m)Tc-Evans blue is an agent that has both radioactive and color signals in a single dose. Previous studies in smaller animal models suggested that this agent could have advantages over the dual-injection technique of radiocolloid/blue dye. Doses of (99m)Tc-Evans blue ( approximately 21 MBq) containing Evans blue dye (approximately 4 mg) were administered to the hind limbs or fore limbs of sheep to map the lymphatic drainage patterns, validate its ability to identify the sentinel lymph node, and examine the reproducibility of the technique. The study protocol was repeated with (99m)Tc-antimony trisulfide colloid and Patent Blue V dye. After the operative exposure, lymph nodes were identified with the gamma probe and then excised and analyzed for radioactivity (percentage of injected dose) and blue color. After the administration of (99m)Tc-Evans blue, all lymph nodes harvested (35 of 35) in either short chains or long basins were hot and blue. The sentinel lymph nodes concentrated more radioactivity than the second-tier nodes to the extent of 2:1 to 215:1. For radiocolloid/Patent Blue V, the ratios were lower, at 2:1 to 3:1. (99m)Tc-Evans blue was found to better discriminate the sentinel lymph node than (99m)Tc-antimony trisulfide colloid/Patent Blue V in variable multitier lymph node anatomy, and it is an agent that promises to have positive clinical applications.

  18. Historical Trends in Neonatal Nursing: Developmental Care and NIDCAP.

    PubMed

    Kaye, Spence

    2016-01-01

    The focus of neonatal nursing has shifted from a highly technical approach to one of supportive interventions and a more individualized developmental approach. Developmental care is described as a philosophy of care that requires rethinking the relationships between infants, families, and healthcare professionals. Various models of developmental care exist; however, they all include a variety of activities designed to manage the environment and individualize the care provided to premature and/or sick infants.

  19. Singapore Neonatal Resuscitation Guidelines 2016

    PubMed Central

    Yeo, Cheo Lian; Biswas, Agnihotri; Ee, Teong Tai Kenny; Chinnadurai, Amutha; Baral, Vijayendra Ranjan; Chang, Alvin Shang Ming; Ereno, Imelda Lustestica; Ho, Kah Ying Selina; Poon, Woei Bing; Shah, Varsha Atul; Quek, Bin Huey

    2017-01-01

    We present the revised Neonatal Resuscitation Guidelines for Singapore. The 2015 International Liaison Committee on Resuscitation Neonatal Task Force’s consensus on science and treatment recommendations (2015), and guidelines from the American Heart Association and European Resuscitation Council were debated and discussed. The final recommendations of the National Resuscitation Council, Singapore, were derived after the task force had carefully reviewed the current available evidence in the literature and addressed their relevance to local clinical practice. PMID:28741001

  20. Modified Evans blue fluorimetry for determination of pulmonary vascular permeability in rats sustaining burns, and delayed fluid resuscitation of burn shock.

    PubMed

    Lu, W; Chen, Y; Xia, Z; Fang, Z

    1997-09-01

    The present experiment used modified Evans blue fluorimetry to determine changes in pulmonary vascular permeability using a delayed resuscitation model of burn shock in rats. The results showed that pulmonary vascular permeability in the immediate resuscitation (IR) group regressed to normal 12-24 h following the burn whereas it regressed slowly in the delayed resuscitation (DR) group. The study showed that Evans blue fluorimetry is a reliable and sensitive method for determining pulmonary vascular permeability, and dimethyl formamide is a preferable extracting solution which provides a quick and convenient means for scientific research.

  1. Pre-, peri- and neonatal risk factors for autism.

    PubMed

    Guinchat, Vincent; Thorsen, Poul; Laurent, Claudine; Cans, Christine; Bodeau, Nicolas; Cohen, David

    2012-03-01

    To identify pre-, peri- and neonatal risk factors for pervasive developmental disorders (PDD). We searched the Medline database through March 2011 for relevant case-control and population-based studies on pre-, peri- and neonatal hazards related to PDD, including autism. We identified 85 studies for this review. Data were extracted systematically and organized according to risk factors related to family history, pregnancy, gestational age, delivery, birth milestones and the neonate's condition at birth. During the prenatal period, risk factors for PDD were advanced maternal or paternal ages, being firstborn vs. third or later, maternal prenatal medication use and mother's status as foreign born. During the perinatal and neonatal periods, the risk factors for PDD were preterm birth, breech presentation, planned cesarean section, low Apgar scores, hyperbilirubinemia, birth defect and a birthweight small for gestational age. The influence of maternal pre-eclampsia, diabetes, vomiting, infections and stress during pregnancy requires further study in order to determine risk for PDD. Despite evidence for the association of some pre-, peri- and neonatal risk factors associated with PDD, it remains unclear whether these risks are causal or play a secondary role in shaping clinical expression in individuals with genetic vulnerability. A plausible hypothsesis is that improvements in obstetric and neonatal management have led to an increased rate of survivors with pre-existing brain damage. Given the variety of risk factors, we propose that future studies should investigate combinations of multiple factors, rather than focusing on a single factor. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  2. Neonatal Sepsis and Inflammatory Mediators

    PubMed Central

    Reis Machado, Juliana; Soave, Danilo Figueiredo; da Silva, Marcos Vinícius; de Menezes, Liliana Borges; Etchebehere, Renata Margarida; Monteiro, Maria Luiza Gonçalves dos Reis; Antônia dos Reis, Marlene; Corrêa, Rosana Rosa Miranda; Celes, Mara Rúbia Nunes

    2014-01-01

    Neonatal sepsis is a major cause of morbidity and mortality and its signs and symptoms are nonspecific, which makes the diagnosis difficult. The routinely used laboratory tests are not effective methods of analysis, as they are extremely nonspecific and often cause inappropriate use of antibiotics. Sepsis is the result of an infection associated with a systemic inflammatory response with production and release of a wide range of inflammatory mediators. Cytokines are potent inflammatory mediators and their serum levels are increased during infections, so changes from other inflammatory effector molecules may occur. Although proinflammatory and anti-inflammatory cytokines have been identified as probable markers of neonatal infection, in order to characterize the inflammatory response during sepsis, it is necessary to analyze a panel of cytokines and not only the measurement of individual cytokines. Measurements of inflammatory mediators bring new options for diagnosing and following up neonatal sepsis, thus enabling early treatment and, as a result, increased neonatal survival. By taking into account the magnitude of neonatal sepsis, the aim of this review is to address the role of cytokines in the pathogenesis of neonatal sepsis and its value as a diagnostic criterion. PMID:25614712

  3. An unusual cause of neonatal cyanosis…

    PubMed Central

    Carreira, Raquel; Palaré, Maria João; Prior, Ana Rita; Garcia, Paula; Abrantes, Margarida

    2015-01-01

    We report a case of a female neonate whose pulse oximetry screening for congenital heart disease at 40 h of life was positive. The pregnancy was uneventful with no relevant family history. The neonate presented with bluish discolouration of the skin lasting until day 15. Cardiovascular examination and chest radiography were normal. Septic screening was negative. Oxygen therapy was started with poor response; investigations revealed a methaemoglobinaemia of 7.4%. The methaemoglobin level reached a peak of 15% on day 10, falling thereafter. The infant was discharged by day 20 with a normal physical examination and a methaemoglobinaemia of 11.4%. By 2 months of age this had fallen to 2.4%. Further investigation revealed a haemoglobin M variant: a heterozygous mutation of the γ globin gene known as Hb F-M Viseu. The mutation occurs in the γ chain, therefore the methaemoglobinaemia is transitory, resolving with the transition from fetal to adult haemoglobin. PMID:25754164

  4. An unusual cause of neonatal cyanosis….

    PubMed

    Carreira, Raquel; Palaré, Maria João; Prior, Ana Rita; Garcia, Paula; Abrantes, Margarida

    2015-03-09

    We report a case of a female neonate whose pulse oximetry screening for congenital heart disease at 40 h of life was positive. The pregnancy was uneventful with no relevant family history. The neonate presented with bluish discolouration of the skin lasting until day 15. Cardiovascular examination and chest radiography were normal. Septic screening was negative. Oxygen therapy was started with poor response; investigations revealed a methaemoglobinaemia of 7.4%. The methaemoglobin level reached a peak of 15% on day 10, falling thereafter. The infant was discharged by day 20 with a normal physical examination and a methaemoglobinaemia of 11.4%. By 2 months of age this had fallen to 2.4%. Further investigation revealed a haemoglobin M variant: a heterozygous mutation of the γ globin gene known as Hb F-M Viseu. The mutation occurs in the γ chain, therefore the methaemoglobinaemia is transitory, resolving with the transition from fetal to adult haemoglobin. 2015 BMJ Publishing Group Ltd.

  5. Neonatal Marfan syndrome: Report of two cases.

    PubMed

    Jurko, Tomas; Jurko, Alexander; Minarik, Milan; Micieta, Vladimir; Tonhajzerova, Ingrid; Kolarovszka, Hana; Zibolen, Mirko

    2017-07-01

    Marfan syndrome is rarely diagnosed in the neonatal period because of variable expression and age-dependent appearance of clinical signs. The prognosis is usually poor due to high probability of congestive heart failure, mitral and tricuspid regurgitations with suboptimal response to medical therapy and difficulties in surgical management. The authors have studied two cases of Marfan syndrome in the newborn period. Two cases of neonatal Marfan syndrome, one male and one female, were diagnosed by characteristic physical appearance. Both infants had significant cardiovascular abnormalities diagnosed by ultrasonography. Genetic DNA analysis in the second case confirmed the mutations in the fibrillin-1 gene located on chromosome 15q21 which is responsible for the development of Marfan syndrome. The boy died at six weeks of age with signs of rapidly progressive left ventricular failure associated with pneumonia. The second infant was having only mild signs of congestive heart failure and has been treated with beta blockers. At the age of 4 years her symptoms of congestive heart failure had worsened due to progression of mitral and tricuspid insufficiency and development of significant cardiomegaly. Mitral and tricuspid valvuloplasy had to be done at that time. Early diagnosis of Marfan syndrome in the newborn period can allow treatment in the early stages of cardiovascular abnormalities and may improve the prognosis. It also helps to explain to the family the serious health problem of their child.

  6. Experimenting with the Family in the Newborn Period: A Commentary.

    ERIC Educational Resources Information Center

    Worobey, John; Brazelton, T. Berry

    1986-01-01

    Responds to Belsky's critique of the Neonatal Behavioral Assessment Scale and suggests explanations for the disparity in results when using the Scale as an intervention device with new families. (HOD)

  7. [Neonatal Volkmann's syndrome].

    PubMed

    Dandurand, M; Michel, B; Fabre, C; Stoebner, P; Meunier, L

    2009-11-01

    , excessive maternal weight gain or diabetes. Our case emphasized three main points. First, the diagnostic value of early MR angiography in the event of associated extensive tissue oedema, multiple arterial compression and decreased vascular perfusion. Second, the role of shoulder dystocia in triggering the traumatic factor reported for the first time. Third, the role of neuroleptic and anxiolytic treatments taken by the mother during pregnancy. Prazepam is a long-acting benzodiazepine that can cause impregnation and withdraw syndromes in neonates. Impregnation "floppy infant syndrome" is an early event characterized by hypotonia, hypoventilation and lethargy. Hypotonia and decreased foetal movements may favour prolonged pressures and malposition with secondary crush injury during delivery. Maternal medication has not been cited hitherto as an aetiological factor in neonatal compartment syndrome.

  8. [Extra-articular arthroereisis according to Grice/Green versus calcaneal lengthening according to Evans: retrospective comparison for therapy of neurogenic pes planovalgus].

    PubMed

    Waizy, H; Plaass, C; Brandt, M; Herold, D; Stukenborg-Colsman, C; Windhagen, H; Claassen, L

    2013-06-01

    Common reasons for juvenile neurogenic pes planovalgus are hypoxic brain damage, birth defects of the spinal canal, trauma and cerebral cancer. When symptoms persist despite conservative treatment of symptomatic pes planovalgus, surgery is indicated. Objectives of the operation are improved gait and mobilization as well as an improved basis for wearing shoes. Joint preserving and ankylosing procedures as well as combinations of both are available. The aim of this study was a retrospective comparison of the Grice/Green extra-articular arthroreisis versus the Evans calcaneal lengthening operation. Between October 2001 and October 2009 a total of 75 arthroereisis operations were performed according to Grice/Green and in the period from April 2006 to February 2010 a total of 83 calcaneal lengthening operations according to Evans. The focus of the study was on patients with an underlying neurogenic disease which resulted in 72 cases in the Grice/Green group and 70 cases in the Evans group. The average age was 14.6 ± 5.0 years in the Evans group and 10.1 ± 3.4 years in the Grice/Green group. Of the patients in the Grice/Green group 17 had infantile cerebral palsy (ICP) and 25 had other neuromuscular diseases and in the Evans group 14 patients had ICP and 28 patients had other neuromuscular diseases. The medical records, preoperative and postoperative radiographs were analyzed. In addition information was obtained on the quality of life (EQ-5D), mobility and the supply of mobility aids using a specially designed questionnaire. The radiological evaluation was based on preoperative and postoperative lateral and dorso-plantar radiographs. The follow-up time for the questionnaire was on average 54 months (range 12-109 months) for the Grice/Green group and 22 months (range 9-53 months) for the Evans group. The postoperative treatment was similar in both groups. The talometatarsal (TMT) index could be improved by surgery according to Grice/Green from - 50.2° to -

  9. Mozart K.448 attenuates spontaneous absence seizure and related high-voltage rhythmic spike discharges in Long Evans rats.

    PubMed

    Lin, Lung-Chang; Juan, Chun-Ting; Chang, Hsueh-Wen; Chiang, Ching-Tai; Wei, Ruey-Chang; Lee, Mei-Wen; Mok, Hin-Kiu; Yang, Rei-Cheng

    2013-05-01

    Recent research has revealed more evidence supporting the positive effects of music on humans and animals. However, evidence of music's effects on improving epilepsy in animals is sparse. This study aimed to clarify the influence of Mozart's music in Long Evans rats, which are characterized by spontaneous absence epilepsy (SAE) and high-voltage rhythmic spike (HVRS) discharges. Continuous electroencephalograms comprised of HVRS discharges, and behavioral performance were recorded in Long Evans rats (n=5) before, during, and after exposure to the Mozart's Sonata for Two Pianos in D Major, K.448 (Mozart K.448). The same evaluation was repeated after they had been subjected to daily exposure of the music for 20 days. Seizure frequencies and spontaneous HVRS discharges were reduced in all of the SAE rats during and after music exposure compared with the pre-music stage. The average seizure frequencies were 79.8±24.6, 48±15.2, and 33±12.1/h before, during, and after music exposure, respectively. The average run of spike episodes were 84.6±18.4, 52±17.8, and 36.8±16.9/h before, during, and after music exposure, respectively. The seizure frequencies and related run of spike episodes decreased by 39.8% and 38.5% during, and 58.6% and 56.6% post music exposure, respectively. The average run of spike durations and spike numbers also showed significant decreases (reduction by 47.1%, 47.8% during music and 60.8%, 61.3% post music). After daily music exposure for 20 days, the number of HVRS discharges and seizure frequencies during and after music exposure, however, showed no further accumulative reduction or adaptation effect. These results suggest that Mozart K.448 had a positive short-term effect in attenuating the spontaneous HVRS discharges in Long Evans rats. However, the mechanism needs further investigation. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Hydrology, microbiology and carbon cycling at a high Arctic polythermal glacier, (John Evans Glacier, Ellesmere Island, Canada)

    NASA Astrophysics Data System (ADS)

    Skidmore, Mark Leslie

    Analysis of the hydrology, hydrochemistry and microbiology at polythermal John Evans Glacier and geochemical and isotopic data from Haut Glacier d'Arolla demonstrates that certain subglacial chemical weathering processes are microbially mediated. Subglacial drainage is likely an annual occurrence beneath John Evans Glacier and solute rich subglacial waters indicate over winter storage at the glacier bed. Subglacial microbial populations are also present, and are viable under simulated near in situ conditions at 0.3°C. This suggests that temperate subglacial environments at a polythermal glacier, which are isolated by cold ice above and around them, provide a viable habitat for life where basal water and organic carbon are present throughout the year. Thus, a subglacial microbial ecosystem based upon legacy carbon, (from old soils or surface inputs) rather than primary production may exist, where redox processes are a key component, and seasonal anoxia may occur. The existence of anoxic environments is supported by the presence of strictly anaerobic bacteria (sulphate reducing bacteria and methanogens) in the basal sediments---which are viable in culture at 4°C---and also argues that these bacteria are not washed in with oxygenated surface meltwaters, but are present in the subglacial environment. During the summer meltseason there is a large input of surficial waters to the subglacial system and water residence times are drastically reduced. Hence, kinetic weathering processes dominate, resulting in light delta 13C-DIC (dissolved inorganic carbon) in glacial runoff, as verified by experimental work on CaCO3 and John Evans Glacier sediments. The experiments demonstrate kinetic bedrock fractionation (KBF) during carbonate hydrolysis and that kinetic fractionation of CO2 (KFC) is proportional to the rate of CO2 draw down during the carbonation of carbonates. This results in significantly depleted delta13C-DIC values (≤-16 ‰) relative to the bedrock carbonate

  11. Adrenergic and cholinergic regulation of in vitro melatonin release during ontogeny in the pineal gland of Long Evans rats.

    PubMed

    Wagner, G; Brandstätter, R; Hermann, A

    2000-09-01

    Melatonin, produced by the pineal gland, plays an important role in a great variety of neuroendocrine functions. The rhythmic release of melatonin by the mammalian pineal gland is regulated by norepinephrine (NE) acting via alpha- and beta-adrenergic receptors utilizing distinct signal transduction pathways. Acetylcholine has been demonstrated to exert various effects in the mammalian pineal gland, including an inhibitory action on the NE-induced stimulation of melatonin production. However, data obtained by different laboratories on the interaction of adrenergic receptors are not consistent and whether muscarinic and/or nicotinic receptors participate in the various effects of acetylcholine is still contradictory. To investigate noradrenergic as well as cholinergic mechanisms during ontogeny, we have investigated in vitro melatonin release from isolated pineal glands of Long Evans rats of different ages. NE as well as the beta-adrenergic receptor agonist isoproterenol (ISO) significantly elevated the melatonin release in pineal glands from postnatal week 2 on. In pineal glands originating from 2- to 4-week-old rats, simultaneous activation of alpha- and beta-adrenergic receptors by ISO and the alpha-adrenergic receptor agonist methoxamine (MET) or NE resulted in significantly weaker stimulation of melatonin production than beta-receptor activation alone. Acetylcholine evoked a significant increase in melatonin release in pineal glands from 2- to 4-week-old rats. In pineal glands from 8- to 20-week-old animals, ISO, ISO + MET or NE stimulated pineal melatonin release to comparable maxima, whereas acetylcholine was without effect. Our data indicate (1) that the adrenergic stimulation of pineal melatonin production in Long Evans rats is dominated by a beta-adrenergic mechanism, (2) that additional alpha-adrenergic receptor activation is inhibitory and (3) dependent on the developmental status of the animal, and (4) that acetylcholine acting via muscarinic receptors

  12. Neonatal haemochromatosis with reversible pituitary involvement.

    PubMed

    Indolfi, Giuseppe; Bèrczes, Rita; Pelliccioli, Isabella; Bosisio, Michela; Agostinis, Cristina; Resti, Massimo; Zambelli, Marco; Lucianetti, Alessandro; Colledan, Michele; D'Antiga, Lorenzo

    2014-08-01

    Neonatal haemochromatosis is a rare alloimmune gestational disease with a high mortality. The hallmark of neonatal haemochromatosis is severe neonatal liver failure associated with extrahepatic siderosis. Thus far, no pituitary dysfunction has been reported to result from the tissue damage associated with extrahepatic siderosis. The present report describes a neonate with neonatal haemochromatosis and secondary hypothyroidism associated with pituitary iron deposition. Both the conditions were successfully treated by ABO-incompatible liver transplantation. Pituitary gland dysfunction is another possible extrahepatic manifestation of neonatal haemochromatosis, and it is reversible after liver transplantation.

  13. Environmental enrichment attenuates the blood brain barrier dysfunction induced by the neonatal hypoxia-ischemia.

    PubMed

    Diaz, Ramiro; Miguel, Patrícia Maidana; Deniz, Bruna Ferrary; Confortim, Heloísa Deola; Barbosa, Sílvia; Mendonça, Monique Culturato Padilha; da Cruz-Höfling, Maria Alice; Pereira, Lenir Orlandi

    2016-10-01

    Environmental enrichment (EE) is considered an efficient neuroprotector against neonatal hypoxia-ischemia (HI). Nevertheless, the mechanisms involved are not yet clear. In this context, the aim of this study was to investigate the effects of neonatal HI and environmental stimulation in the hippocampus of rats at 3 different time points (PND 8, 22 and 60), evaluating some aspects of BBB structure and function. Seven-day-old Wistar rats were divided into four groups: a control group maintained in a standard environment (CTSE), a control group maintained in an enrichment environment (CTEE), an HI group maintained in a standard environment (HISE) and an HI group maintained in an enrichment environment (HIEE). At the 7th postnatal day (PND), rats were submitted to the Levine-Rice model of neonatal HI. This method consists of permanent occlusion of the right common carotid artery with subsequent exposure to hypoxia. Rats from CTEE and HIEE were stimulated with environmental enrichment. The EE protocol started 24h after HI, in which pup rats with their dams were stimulated in a maintained EE (PND 8-22). Subsequently, animals were submitted to daily EE (1h/day, PND 23-60). The expression of some proteins involved in BBB structure (β-catenin, occludin, connexin-43, aquaporin-4, glut-1 and GFAP) were quantified by western blotting in the hippocampi of rats in three periods, at PND 8, 22 and 60. The BBB permeability and integrity was assessed by Evans blue staining and the immunohistochemistry for GFAP in the CA1 region of the hippocampus were also performed. The results showed an HI-induced decreased occludin expression at PND 22 and low levels of occludin, β-catenin and GFAP at PND 60 in the hippocampus of the hypoxic-ischemic rats. Interestingly, in young and adult rats, EE reversed these effects. Evans blue extravasation into the brain parenchyma confirmed the BBB dysfunction brought on by HI. No differences were observed at PND 8, probably due to the immaturity of the

  14. Incontinentia pigmenti in the neonatal period

    PubMed Central

    Rodrigues, Vera; Diamantino, Filipa; Voutsen, Olga; Cunha, Manuel Sousa; Barroso, Rosalina; Lopes, Maria João Paiva; Carreiro, Helena

    2011-01-01

    Incontinentia pigmenti (IP) is a rare multisystem disease, X linked dominant disorder. As all X linked dominant diseases, it is usually male-lethal. Female newborn admitted to the neonatal intensive care unit on the first day of life was diagnosed as having probable herpetic infection with vesicular skin lesions distributed on upper right limb and inferior limbs. Family history showed that her 22-year-old mother had hypopigmented lesions on the lower limbs and her 13-month-old sister had hyperpigmented lesions on the trunk and limbs. In newborns, herpes infection emerges as the principal diagnosis of vesicular rash, due to the importance of precocious diagnosis and treatment. Other hypothesis must be considered in a newborn with vesicobullous rash, such as IP. PMID:22688469

  15. The role of small proliferative adipocytes in the development of obesity: comparison between Otsuka Long-Evans Tokushima Fatty (OLETF) rats and non-obese Long-Evans Tokushima Otsuka (LETO) rats.

    PubMed

    Hanamoto, Takayuki; Kajita, Kazuo; Mori, Ichiro; Ikeda, Takahide; Fujioka, Kei; Yamauchi, Masahiro; Okada, Hideyuki; Usui, Taro; Takahashi, Noriko; Kitada, Yoshihiko; Taguchi, Koichiro; Kajita, Toshiko; Uno, Yoshihiro; Morita, Hiroyuki; Ishizuka, Tatsuo

    2013-01-01

    Obesity consists of hypertrophy and hyperplasia of adipocytes. Although the number of adipocytes is influenced by anatomical location, nutritional environment, hormone and genetic variation, it has been thought to be determined by the proliferation of precursor cells and subsequent differentiation. However, our recent research has identified the population of small adipocytes less than 20 μm in diameter, exhibiting tiny or no lipid droplets and expressing adipocyte marker proteins (small proliferative adipocytes: SPA) in isolated adipocytes. Notably, 5-bromo-2'-deoxyuridine (BrdU) incorporation and proliferating cell nuclear antigen (PCNA) expression were detected in these cells. In this study, we investigated the role of SPA in development of adipose tissue using genetically obese diabetic Otsuka Long-Evans Tokushima Fatty (OLETF) rats and their non-obese and non-diabetic littermates, Long-Evans Tokushima Otsuka (LETO) rats. Proliferation of SPA was determined by measurement of PCNA at the protein level in isolated fractions of adipocytes with collagenase digestion. In general, expression levels of PCNA rose, reached a maximum, and declined in adipose tissues during aging. The expression levels of PCNA were maximum in epididymal fat at 32 w and 12 w of age in LETO and OLETF, respectively. They reached the maximum at 20 w of age both in LETO and OLETF in mesenteric fat. Although the PCNA expression level was higher in OLETF in the early period, it reversed later. Enlargement of adipocytes developed during aging, which was enhanced when the expression levels of PCNA declined. These results suggest that proliferation of SPA may prevent adipocyte hypertrophy and the resultant development of metabolic disorders.

  16. Neonatal lupus erythematosus.

    PubMed

    Yokogawa, Naoto; Sumitomo, Naofumi; Miura, Masaru; Shibuya, Kazuhiko; Nagai, Hiroshi; Goto, Mikako; Murashima, Atsuko

    2017-01-01

      Neonatal lupus (NL), a passively-acquired autoimmune disease associated with maternal anti-SSA antibody, presents both cardiac manifestations such as cardiac NL and non-cardiac manifestations including rashes, cytopenia, and hepatic abnormalities. Cardiac NL, occurring in 1-2% of anti-SS-A antibody-positive mothers, is a life-threatening complication with a mortality rate of 20% and a pacemaker implantation rate of 70%. In contrast, cutaneous NL, which is more common than cardiac NL, usually resolves in six months. Since half of NL cases occur in asymptomatic mothers, if an infant presents characteristic cutaneous or cardiac manifestations of NL, the mother should be tested for anti-SS-A antibody. In mothers positive for anti-SS-A antibody, the risk of having a child with cardiac NL increases ten-fold and five-fold for a previous child with cardiac NL and cutaneous NL, respectively. A joint American, British, and French retrospective study of NL registries showed that hydroxychloroquine (HCQ) reduced the cardiac NL risk in subsequent pregnancies in mothers who previously had a child with cardiac NL. A prospective open-label study to confirm this effect is being undertaken in the USA. A similar prospective multi-center study will be undertaken in Japan. Establishing a Japanese registry of children with NL and subsequent pregnancies of their mothers will help promote clinical research in NL in Japan.

  17. Neonatal invasive candidiasis.

    PubMed

    Stronati, M; Decembrino, L

    2006-12-01

    Over the last two decades, systemic fungal infections have emerged to play a primary role in hospital-acquired infections. C. albicans is involved in 75% of neonatal candidiasis; however, the incidence of infection from C. parapsilosis is also increasing significantly. The higher incidence observed in the high-risk group of very low birth weight (VLBW) infants is linked to their special physical characteristics and the diagnostic and therapeutic invasive procedures they undergo. Colonization is a relevant risk factor depending on the colonized site , the fungal species and the type of colonization. Serological tests have a low specificity and sensitivity; in many cases, they do not distinguish between colonization and infection. Blood culture, although the best diagnostic test for determining systemic infection, can result negative, even in cases of deep organ involvement. In addition, fungi grow more slowly than bacteria in cultures. So, the difficulty in diagnosing systemic candidiasis and its aspecific clinical features may make empirical therapy appropriate. Amphotericin B (AmB) alone or combined with 5-fluorocytosine remains the drug of choice. Fluconazole represents a valid alternative. Recently developed new formulations of amphotericin incapsulated in liposomes can avoid possible adverse effects. Prognosis depends on the specific micro-organism involved; mortality is higher in the presence of C. albicans. As prognosis is associated with high mortality, prevention measures to reduce risk factors are of critical importance.

  18. Porcine Neonatal Coccidiosis

    PubMed Central

    Sanford, S. E.; Josephson, G. K. A.

    1981-01-01

    Coccidia were identified in intestinal sections from 82 piglets comprising 37 consignments from 34 farms, and represented a yearly increasing incidence in the three years 1978 to 1980. Piglets were primarily from medium to large farms with intensive, continuous-farrowing, confinement-rearing programs. Piglets, usually five days to 15 days old, had yellow, fluid diarrhea, became unthrifty and sometimes died. In six piglets from two farms, a green, adherent, fibrinonecrotic membrane was seen throughout most of the jejunum and ileum. Significant gross lesions were not observed in the other 76 piglets. Moderate to severe villous atrophy of jejunum and ileum was seen histologically. Various asexual and sexual stages of coccidia were seen within parasitophorous vacuoles of villar epithelial cells. Multifocal erosions with necrosis of villar tips and occasionally more diffuse mucosal necrosis with fibrinocellular exudate were seen. Isospora suis oocysts were identified in feces from several weaners from one farm. Amprolium and decoquinate mixed in the sow ration at 1 kg/tonne for three weeks prior to and postfarrowing was moderately successful in stopping outbreaks of neonatal diarrhea associated with coccidiosis. ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6. PMID:7343074

  19. Safety of neonatal phototherapy lamp exposure.

    PubMed

    Clarkson, Douglas McG; Satodia, P; Hadley, Ian

    2016-12-01

    A routine review of light exposure within a neonatal intensive care unit is described following the introduction of a new model of neonatal phototherapy lamp. Spectral measurements were undertaken using a Bentham Dmc150 spectroradiometer system. Safety assessments were undertaken based on likely exposure of parents at the cot side, neonates in adjacent cots and the effectiveness of eye protection for neonates with direct phototherapy. An aphakic eye response was used for assessment of neonatal risk and the blue-light response for estimation of adult exposure using current ICNIRP guidelines. Such estimations indicated exposure levels of parents at the cot side and neonates in adjacent cots were within current established safe limits. The level of light blocking provided by the available neonatal eye protection was estimated to be entirely adequate and presented no hazard to the infant when correctly positioned over the neonate. It is likely, however, that an increased safety factor is potentially present for the neonate due to the fact that the neonate's eyes will typically be shut for over 50% of the time. It is identified, however, that the aphakic response is essentially associated with mature adult retinal cells, and that the maturing cells of the neonate may exhibit additional light sensitivity, especially in the case of premature infants. Changes in neonatal physiology associated with neonatal phototherapy are discussed, which may influence mechanisms of light-induced retinal damage.

  20. Transfer of label from 3H-glucose in Digitaria eriantha leaves to the rust fungus Puccinia digitariae Pole Evans.

    PubMed

    Rey, M E; Garnett, H M

    1985-08-01

    Digitaria eriantha pentzii was fed 3H-glucose prior to inoculation with uredospores of Puccinia digitariae Pole Evans. Twenty-one hours after inoculation, uptake of label from 3H-glucose by the primary infection structures of P. digitariae was demonstrated employing autoradiography. These results indicate that an exchange of nutrients between host and pathogen occurs very early on in the infection process, during the formation of the primary infection structures. Despite contrary reports that obligate parasites receive no nutrition before establishment of haustoria, this study supports the work of Andrews (Can J Bot 53:1103, 1975), who demonstrated uptake of 3H-glucose label from lettuce cotyledons into the primary and secondary infection vesicles, appressoria, and germ tubes of Bremia lactucae.

  1. Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome concomitant with immune hemolytic anemia and immune thrombocytopenic purpura (Evans syndrome).

    PubMed

    Korkmaz, Huseyin; Bugdaci, Mehmet Sait; Temel, Tuncer; Dagli, Mehmet; Karabagli, Pinar

    2013-04-01

    Autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) associated with Evans syndrome; combination of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenic purpura (ITP) has rarely been reported. We report the case of a 53-year-old patient who presented with weakness, myalgia, arthralgia, shortness of breath and purpura. Initial laboratory investigations revealed liver dysfunction, anemia and thrombocytopenia. Anti-nuclear (ANA) and antimitochondrial M2 (AMA M2) antibodies were positive. Diagnose of PBC-AIH overlap was made by clinical, serological and histological investigations. AIHA and ITP was identified with clinical-laboratory findings and bone marrow puncture. She was treated with IVIG followed by prednisolone and ursodeoxycholic acid. Hemoglobin-thrombocytes increased rapidly and transaminases improved at day 8. We have reported the first case in the literature with AIH-PBC overlap syndrome concurrent by ITP and AIHA which suggest the presence of shared genetic susceptibility factors in multiple autoimmune conditions including AIH, PBC, ITP and AIHA.

  2. Myths and verities in protein folding theories: From Frank and Evans iceberg-conjecture to explanation of the hydrophobic effect

    NASA Astrophysics Data System (ADS)

    Ben-Naim, Arieh

    2013-10-01

    Starting from the seminal article by Frank and Evans where the "iceberg formation" idea was first expressed, we follow the evolution of this idea to the explanation of the hydrophobic effect. We show that the idea of iceberg formation can provide an explanation to the entropy, and enthalpy of solvation of non-polar solutes in water, provided one first explains why a simple non-polar solute would form icebergs in the first place. Having done that, the questions regarding the outstanding large hydrophobic solvation Gibbs energy remains unexplained. This conclusion follows from the exact entropy-enthalpy-compensation pertaining to any structural changes induced in the solvent. We also comment on some misinterpretation of the partial molar heat capacity of non-polar solutes in water.

  3. Chemical Conjugation of Evans Blue Derivative: A Strategy to Develop Long-Acting Therapeutics through Albumin Binding.

    PubMed

    Chen, Haojun; Wang, Guohao; Lang, Lixin; Jacobson, Orit; Kiesewetter, Dale O; Liu, Yi; Ma, Ying; Zhang, Xianzhong; Wu, Hua; Zhu, Lei; Niu, Gang; Chen, Xiaoyuan

    2016-01-01

    The efficacy of therapeutic drugs is highly dependent on their optimal in vivo pharmacokinetics. Albumin conjugation is considered to be one of the most effective means of protracting the short lifespan of peptides and proteins. In this study, we proposed a novel platform for developing long lasting therapeutics by conjugating a small molecular albumin binding moiety, truncated Evans blue, to either peptides or proteins. Using the anti-diabetic peptide drug Exendin-4 as a model peptide, we synthesized a new long-acting Exendin-4 derivative (denoted as Abextide). Through complexation with albumin in situ, the biological half-life of Abextide was significantly extended. The hypoglycemic effect of Abextide was also improved remarkably over Exendin-4. Thus, Abextide has considerable potential to treat type 2 diabetes. This strategy as a general technology platform can be applied to other small molecules and biologics for the development of long-acting therapeutic drugs.

  4. Chemical Conjugation of Evans Blue Derivative: A Strategy to Develop Long-Acting Therapeutics through Albumin Binding

    PubMed Central

    Chen, Haojun; Wang, Guohao; Lang, Lixin; Jacobson, Orit; Kiesewetter, Dale O.; Liu, Yi; Ma, Ying; Zhang, Xianzhong; Wu, Hua; Zhu, Lei; Niu, Gang; Chen, Xiaoyuan

    2016-01-01

    The efficacy of therapeutic drugs is highly dependent on their optimal in vivo pharmacokinetics. Albumin conjugation is considered to be one of the most effective means of protracting the short lifespan of peptides and proteins. In this study, we proposed a novel platform for developing long lasting therapeutics by conjugating a small molecular albumin binding moiety, truncated Evans blue, to either peptides or proteins. Using the anti-diabetic peptide drug Exendin-4 as a model peptide, we synthesized a new long-acting Exendin-4 derivative (denoted as Abextide). Through complexation with albumin in situ, the biological half-life of Abextide was significantly extended. The hypoglycemic effect of Abextide was also improved remarkably over Exendin-4. Thus, Abextide has considerable potential to treat type 2 diabetes. This strategy as a general technology platform can be applied to other small molecules and biologics for the development of long-acting therapeutic drugs. PMID:26877782

  5. Additional information for “TREMOR: A Wireless, MEMS Accelerograph for Dense Arrays” (Evans et al., 2003)

    USGS Publications Warehouse

    Evans, John R.; Hamstra, Robert H.; Spudich, Paul; Kundig, Christoph; Camina, Patrick; Rogers, John A.

    2003-01-01

    The length of Evans et al. (2003) necessitated transfer of several less germane sections to this alternate forum to meet that venue’s needs. These sections include a description of the development of Figure 1, the plot of spatial variability so critical to the argument for dense arrays of strong-motion instruments; the description of the rapid, integer, computational method for PGV used in the TREMOR instrument (the Oakland instrument, the commercial prototype, and the commercial instrument); siting methods and strategies used for Class B TREMOR instruments and those that can be used for Class C instruments to preserve the cost advantages of such systems; and some general discussion of MEMS accelerometers, including a comparative Table with representative examples of Class A, B and C MEMS devices. (“MEMS” means “Micro-ElectroMechanical” Systems—“micromachined” sensors, generally of silicon. Classes A, B, and C are defined in Table 1.)

  6. Identification of Eye-Specific Domains and Their Relation to Callosal Connections in Primary Visual Cortex of Long Evans Rats

    PubMed Central

    Laing, R.J.; Turecek, J.; Takahata, T.; Olavarria, J.F.

    2015-01-01

    Ocular dominance columns (ODCs) exist in many primates and carnivores, but it is believed that they do not exist in rodents. Using a combination of transneuronal tracing, in situ hybridization for Zif268 and electrophysiological recordings, we show that inputs from both eyes are largely segregated in the binocular region of V1 in Long Evans rats. We also show that, interposed between this binocular region and the lateral border of V1, there lies a strip of cortex that is strongly dominated by the contralateral eye. Finally, we show that callosal connections colocalize primarily with ipsilateral eye domains in the binocular region and with contralateral eye input in the lateral cortical strip, mirroring the relationship between patchy callosal connections and specific sets of ODCs described previously in the cat. Our results suggest that development of cortical modular architecture is more conserved among rodents, carnivores, and primates than previously thought. PMID:24969475

  7. Myths and verities in protein folding theories: from Frank and Evans iceberg-conjecture to explanation of the hydrophobic effect.

    PubMed

    Ben-Naim, Arieh

    2013-10-28

    Starting from the seminal article by Frank and Evans where the "iceberg formation" idea was first expressed, we follow the evolution of this idea to the explanation of the hydrophobic effect. We show that the idea of iceberg formation can provide an explanation to the entropy, and enthalpy of solvation of non-polar solutes in water, provided one first explains why a simple non-polar solute would form icebergs in the first place. Having done that, the questions regarding the outstanding large hydrophobic solvation Gibbs energy remains unexplained. This conclusion follows from the exact entropy-enthalpy-compensation pertaining to any structural changes induced in the solvent. We also comment on some misinterpretation of the partial molar heat capacity of non-polar solutes in water.

  8. THE EFFECT OF TARGETED KNOCKOUT MUTATION ON THE TRANSCRIPTIONAL PROFILE OF THE KIDNEY IN TSC2 MUTANT LONG-EVANS (EKER) RATS.

    EPA Science Inventory

    The effect of a targeted knockout mutation on the transcriptional profile of the kidney in
    Tsc2 mutant Long-Evans (Eker) rats.

    Renal cell carcinoma (RCC) is the most common tumor of the adult kidney, accounting
    for up to 80% of malignant renal neoplasms. Hereditary...

  9. THE EFFECT OF TARGETED KNOCKOUT MUTATION ON THE TRANSCRIPTIONAL PROFILE OF THE KIDNEY IN TSC2 MUTANT LONG-EVANS (EKER) RATS.

    EPA Science Inventory

    The effect of a targeted knockout mutation on the transcriptional profile of the kidney in
    Tsc2 mutant Long-Evans (Eker) rats.

    Renal cell carcinoma (RCC) is the most common tumor of the adult kidney, accounting
    for up to 80% of malignant renal neoplasms. Hereditary...

  10. Strain Differences in Dimethylbenz[a]anthracene-Induced Mammary Tumor Incidence in Long Evans and Sprague Dawley Rat Offspring Following Prenatal Atrazine Exposure

    EPA Science Inventory

    It has been shown that prenatal exposure to the chlorotriazine herbicide atrazine (ATR) during mammary bud outgrowth (late gestation) delays postnatal mammary epithelial progression in Long Evans (LE) rats. Our laboratory has recently found that prenatal exposure to ATR also effe...

  11. Effects of prenatal exposure to a low dose atrazine metabolite mixture onpubertal timing and prostate development of male Long-Evans rats

    EPA Science Inventory

    Atrazine (ATR) is a chlorotriazine herbicide extensively used in the US and other countries. Studies examining the effects of adult or developmental ATR exposure on the mammary gland (MG) have used either the Sprague Dawley (SD) or Long-Evans (LE) rat, but no strain comparisons h...

  12. Whole-Genome Sequences and Classification of Streptococcus agalactiae Strains Isolated from Laboratory-Reared Long-Evans Rats (Rattus norvegicus)

    PubMed Central

    Dzink-Fox, J.; Feng, Y.; Shen, Z.; Bakthavatchalu, V.

    2017-01-01

    ABSTRACT In collaboration with the CDC’s Streptococcus Laboratory, we report here the whole-genome sequences of seven Streptococcus agalactiae bacteria isolated from laboratory-reared Long-Evans rats. Four of the S. agalactiae isolates were associated with morbidity accompanied by endocarditis, metritis, and fatal septicemia, providing an opportunity for comparative genomic analysis of this opportunistic pathogen. PMID:28057750

  13. The influence of maternal high fat diet on ozone-induced lung injury and inflammation in Long Evans male and female rat offspring

    EPA Science Inventory

    There is a growing interest in understanding how maternal diet can increase the sensitivity of offspring to environmental exposures. In this study, we examined the influence of high fat diet (HFD) during puberty, pregnancy and lactation in Long Evans rats on the susceptibility of...

  14. Strain Differences in Dimethylbenz[a]anthracene-Induced Mammary Tumor Incidence in Long Evans and Sprague Dawley Rat Offspring Following Prenatal Atrazine Exposure

    EPA Science Inventory

    It has been shown that prenatal exposure to the chlorotriazine herbicide atrazine (ATR) during mammary bud outgrowth (late gestation) delays postnatal mammary epithelial progression in Long Evans (LE) rats. Our laboratory has recently found that prenatal exposure to ATR also effe...

  15. Influencing the nursing commitment to workforce satisfaction and the origins of magnet: an interview with Dr Michael Evans by Jeffrey M. Adams.

    PubMed

    Evans, Michael

    2013-10-01

    This department highlights nursing leaders who have demonstrated a commitment to patient care leadership. This interview profiles Michael Evans, PhD, RN, FAAN, dean of the Texas Tech University School of Nursing and president of the American Nurses Credentialing Center.

  16. Age-related dose response of selected reproductive parameters to acute cadmium chloride exposure in the male Long-Evans rat

    EPA Science Inventory

    Groups of Long Evans rats 30, 50, or 70 days old were injected subcutaneously (s.c.) with a single dose of between 0 and 52 micromoles Cd/Kg as cadmium (CD) chloride. Sixty days post dosing and two hours prior to sacrifice the rats were injected s.c. with 100 IU of hCG to stimula...

  17. Age-related dose response of selected reproductive parameters to acute cadmium chloride exposure in the male Long-Evans rat

    EPA Science Inventory

    Groups of Long Evans rats 30, 50, or 70 days old were injected subcutaneously (s.c.) with a single dose of between 0 and 52 micromoles Cd/Kg as cadmium (CD) chloride. Sixty days post dosing and two hours prior to sacrifice the rats were injected s.c. with 100 IU of hCG to stimula...

  18. Effects of prenatal exposure to a low dose atrazine metabolite mixture onpubertal timing and prostate development of male Long-Evans rats

    EPA Science Inventory

    Atrazine (ATR) is a chlorotriazine herbicide extensively used in the US and other countries. Studies examining the effects of adult or developmental ATR exposure on the mammary gland (MG) have used either the Sprague Dawley (SD) or Long-Evans (LE) rat, but no strain comparisons h...

  19. Expansion of the neonatal platelet mass is achieved via an extension of platelet lifespan

    PubMed Central

    Liu, Zhi-Jian; Hoffmeister, Karin M.; Hu, Zhongbo; Mager, Donald E.; Ait-Oudhia, Sihem; Debrincat, Marlyse A.; Pleines, Irina; Josefsson, Emma C.; Kile, Benjamin T.; Italiano, Joseph; Ramsey, Haley; Grozovsky, Renata; Veng-Pedersen, Peter; Chavda, Chaitanya

    2014-01-01

    The fetal/neonatal hematopoietic system must generate enough blood cells to meet the demands of rapid growth. This unique challenge might underlie the high incidence of thrombocytopenia among preterm neonates. In this study, neonatal platelet production and turnover were investigated in newborn mice. Based on a combination of blood volume expansion and increasing platelet counts, the platelet mass increased sevenfold during the first 2 weeks of murine life, a time during which thrombopoiesis shifted from liver to bone marrow. Studies applying in vivo biotinylation and mathematical modeling showed that newborn and adult mice had similar platelet production rates, but neonatal platelets survived 1 day longer in circulation. This prolonged lifespan fully accounted for the rise in platelet counts observed during the second week of murine postnatal life. A study of pro-apoptotic and anti-apoptotic Bcl-2 family proteins showed that neonatal platelets had higher levels of the anti-apoptotic protein Bcl-2 and were more resistant to apoptosis induced by the Bcl-2/Bcl-xL inhibitor ABT-737 than adult platelets. However, genetic ablation or pharmacologic inhibition of Bcl-2 alone did not shorten neonatal platelet survival or reduce platelet counts in newborn mice, indicating the existence of redundant or alternative mechanisms mediating the prolonged lifespan of neonatal platelets. PMID:24599546

  20. [Situational profile and intervention strategy in the Mesoamerican region in maternal, neonatal and reproductive health area].

    PubMed

    Hernández-Prado, Bernardo; Kestler, Edgar; Díaz, Juan; Walker, Dilys; Langer, Ana; Lewis, Sarah; De la Vara-Salazar, Elvia; Melo-Zurita, María del Carmen; Iriarte, Emma; Danel, Isabella; Donnay, France; Alemán, Denis; Serrano, Roselyn; Morales, Evelyn; Largaespada, Natalia; González, José Douglas Jarquín; Hernández, Ma Del Carmen; Mejía, Claudia E Quiroz; González, Geneva; Carrera, Yadira; Valverde, Clelia; Luna, Rufino; Valencia-Mendoza, Atanacio; Sosa-Rubí, Sandra G; Hernández-Prado, Bernardo; Kestler, Edgar; Díaz, Juan; Walker, Dilys; Langer, Ana; Lewis, Sarah; De la Vara-Salazar, Elvia; Melo-Zurita, María Del Carmen

    2011-01-01

    To present the main results of the regional situation diagnosis and intervention plan developed in 2010 as part of the planning activities of the Mesoamerican Health System by the Working Group on Maternal, Reproductive and Neonatal Health. A group of experts and representatives from countries in the region (Central America and nine southern Mexican states) conducted an exhaustive review of available data to construct a situational analysis and a review of effective practices for improving maternal, reproductive and neonatal health. Finally, the group proposed a regional action plan, defining regional goals and specific interventions. The situational diagnosis suggests that, although there has been progress in the last 10 years, maternal and neonatal mortality rates are still unnaceptably high in the region, with a substantial variability across countries. The group proposed as a regional goal the reduction of maternal and neonatal mortality in accordance with the Millenium Development Goals. The regional plan recommends specific maternal and neonatal health interventions emphasizing obstetric and neonatal emergency care, skilled birth attendance and family planning. The plan also includes a five year implementation strategy, along with training and evaluation strategies. The regional plan for maternal, neonatal and reproductive health has the potential to be successful, provided it is effectively implemented.