婴儿捂热综合征24例临床分析

目的探讨婴儿捂热综合征的发病情况、临床表现及防治措施。方法收集捂热综合征24例,从发病年龄、起病方式、临床表现、实验室检查及治疗等方面进行分析。结果捂热综合征多发生于6个月以下婴儿,急性起病,有明确捂热史,临床表现为高热、大汗、抽搐、意识障碍、呼吸异常等,有血液浓缩、高血钠和酸中毒,神经系统后遗症多见。结论捂热综合征是婴儿常见病,预后不良,应加强育儿教育,预防本病的发生。     

婴儿捂热综合征24例临床分析

目的 探讨婴儿捂热综合征的发病情况、临床表现及防治措施。方法 收集捂热综合征24例，从发病年龄、起病方式、临床表现、实验室检查及治疗等方面进行分析。结果 捂热综合征多发生于6个月以下婴儿，急性起病，有明确捂热史，临床表现为高热、大汗、抽搐、意识障碍、呼吸异常等，有血液浓缩、高血钠和酸中毒，神经系统后遗症多见。结论 捂热综合征是婴儿常见病，预后不良，应加强育儿教育，预防本病的发生。     

游泳与抚触对婴儿神经系统发育影响的研究

目的探讨游泳与抚触对婴儿神经系统发育的影响。方法应用流行病学调查、临床对照研究设实验组和对照组,记录2组婴儿1个月、3个月、6个月时的行为发育指标。结果游泳组神经、行为发育完成的月份提前,各功能区发育以大运动、精细运动、个人交往能区发育商差异显著(P<0.01)。智力发育商数(MDI)和运动发育商数(PDI)比较,差异显著(P<0.01)。结论游泳对婴儿神经系统的发育有促进作用。     

婴儿颅内压

控制颅内压是婴儿神经外科的一项重要工作,对生后头几天,头几个月和头几年的颅内压以往了解很少.自从Ouincke提出腰穿以来有许多报告认为婴儿和儿童的正常压力比成人为低.Merritt提出待6-8岁时其压力才接近于成人.婴儿颅内压1.生后10天或10天以上的压力;28例婴儿大多数不伴有能引起颅内压改变的情况,少数婴儿非常健康,其平均压力45±12mmH_2O柱.2.足月产新生儿压力:作者检查了35个体重为2500克或较大一点(2500克以上),年龄在10天以内的婴儿.在出生当天检查的3例均为正压.生后1-5天检查的23例有10例为负压,6例为零,7例     

新生儿重症监护室高危儿随访率影响因素分析

目的 对新生儿重症监护室(NICU)出院高危儿的随访资料进行分析,以了解影响高危儿随访率的主要相关因素.方法 以我科NICU 2005年6月～2006年6月期间收治的718例高危儿为研究对象,考察他们出院后第一年的随访情况.随访时间安排为出院后一个月内首次随访,后6月内每月随访一次,6～12月每2个月随访一次,1岁内随访超过4次者视为随访成功,随访不足4次或失访则视为随访失败.根据收集的家庭、双亲及婴儿的相关信息,并经单因素Logistic回归分析确立了包括双亲受教育程度、家庭经济收入、家庭居住地、婴儿性别、合并高危因素的多少、NICU住院天数等7个与成功随访有关的自变量,以是否随访成功为因变量,采用SPSS13.0统计软件对数据进行多元逐步Logistic回归分析.结果 居住地、母亲受教育程度、NICU住院天数3个变量对高危儿随访成功的概率有显著影响,被选入Logistic回归方程.而父亲受教育程度、家庭经济收入、婴儿性别、合并高危因素的多少等几个因素对随访成功率的影响不显著.结论 对高危儿实施分级监测管理,建立高危儿监测网络,是提高高危儿随访率、降低人群残障率的有力保障.     

婴儿痉挛症的脑电图及脑地形图分析

婴儿痉挛症是新生儿,婴儿的一种较常见的癲痫。发病早,形式特殊,多伴有发育迟缓或智力低下,因发病短促,症状特异,经常不能及时确诊及治疗,我们将近年内观察的21例婴儿痉挛症脑电图(EEG)及脑地形图(BEAM)的结果分析如下。 1 临床资料与方法 1.1 一般资料 本组患儿21例,男13例,女8例,最小年龄2个月,最大年龄24个月,2～6个月者5例占23.8％,7个月～12个月者14例占66.7％,13个月～24个月者2例占9.5％,平均年龄为9个月。一岁     

CCU患者神经性压力源分析及与谵妄发病率的影响

目的：调查分析CCU （冠心病监护病房）患者神经性压力源及对谵妄发病率的影响。方法采用调查问卷的方式统计我院2013‐01—2013‐12入住CC U 的50例患者的神经性压力源,分析神经性压力源与谵妄发病率的关系。结果CCU患者的精神压力来源于多个方面,其中发病突然、无法与家人见面及生活习惯的被迫改变是患者精神压力的主要来源。通过对不同精神压力程度患者的谵妄发生率观察发现,精神性压力程度越高,谵妄的发生率也越高。结论 CCU患者的神经性压力来源于多个方面,过大压力会导致谵妄发生率上升,应针对压力源为CCU患者进行心理护理。     

精神分裂症首次发病患者治疗依从性的影响因素分析及1年随访

目的:探讨首发精神分裂症患者服药依从性的变化情况及影响因素。方法:采用阳性和阴性症状量表(PANSS)、UKU不良反应量表和服药态度量表(DAI)在治疗前和治疗6个月、治疗12个月对103例精神分裂症患者进行评估,并用线性回归的方法筛选对依从性产生影响的相关因素。结果:治疗12个月时,线性回归分析显示文化程度、精神症状改善情况、不良反应及婚姻与依从性有关(P0.05或P0.01)。治疗6个月时,DAI总分较基线时升高(P0.01),治疗12个月,DAI总分较治疗6个月时下降(P0.01)。结论:受教育程度高、家庭支持好、治疗后症状改善明显、药物不良反应较小的首发精神分裂症患者总体依从性较好;患者的服药依从性随时间推移而逐渐降低。     

新生儿颅内出血存活儿的神经系统后遗症

本文介绍经CT扫描证实为颅内出血的15例婴儿,男婴8例,女婴7例,追踪期至少1年.资料和方法:婴儿胎龄平均32.2周,体重平均1.7公斤.对神经系统恶化和血性脑脊液的婴儿均作CT扫描.神经系统恶化包括感觉丧失,肌张力过低,新生儿反射受抑制,自发和反射活动缺如.经CT扫描显示,出血的严重性与神经系统功能有关.1.围产期危险因素包括:(a)母亲阴道出血,根据产史,特别是前置胎盘或是第三个3个月大的出     

黄疸病史婴幼儿神经行为特点与多动症倾向的相关性分析

目的探讨3岁以内的婴儿多动症倾向与黄疸病史的相关性。方法选取我院2009-01-2014-12儿科评估发育的220例有黄疸病史3岁以内婴儿,随访观察其神经行为状态,采用我院自制神经行为评价表,对0~12个月婴儿与13~36个月婴儿的神经行为作出评价,观察多动症倾向行为,用预测实验方法,对80例0~4个月与40例24~36个月多动症倾向婴儿作黄疸病史预测,分析黄疸病史与多动症倾向的相关性。结果 0~4个月婴儿的黄疸病史预测正确率95%,24~36个月婴儿的黄疸病史预测正确率92.5%,两者差异无统计学意义(P0.05)。结论黄疸病史婴儿与多动症倾向之间存在较大的相关性,医护人员在对黄疸婴儿作出治疗方案时,应尽可能避免多动症倾向的发生。     

Stress,social support and well-being of Arab mothers of children with intellectual disability who are served by welfare services in northern Israel

BACKGROUND: The present study examined the influence of a social support system on the level of stress and the sense of personal well-being of 100 Israeli Arab mothers of young children with special needs. METHODS: Fifty mothers were served by the welfare services in the Nazareth area while 50 did not get help on a regular basis. A comparison was done between educated, urban mothers, and less-educated, rural mothers. RESULTS: The research results point to a relationship between informal support resources, and the marital and economic stress of the mothers: the higher the amount of the informal support resources, the lower the level of stress that was experienced by the mothers. A relationship between the amount of informal support and level of parental stress was not confirmed. A relationship between the amount of support resources and the personal well-being of the mothers was found: the higher the amount of informal support resources, the higher the sense of well-being of the mothers. A relationship between formal support (the welfare services), and level of stress or personal well-being was not found. Education and place of living were not related to level of stress or personal well-being. Educated mothers from urban areas used the formal support (the welfare services) less than less-educated mothers who lived in rural areas. CONCLUSIONS: The findings are interpreted with respect to practice and previous studies.     

Parenting stress in families with very low birth weight preterm infants in early infancy

Taking care of a premature infant adds an extra burden to already stressed parents. Previous studies have shown that parental stress occurs during the initial hospitalization. However, there is little information on parental stress over time, and the few existing results are conflicting. In addition, many studies have focused on maternal stress but there is little information about a father's long-term adaptation to stress. The purpose of this study was to examine the degree and type of parenting stress in the families of very low birth weight (VLBW) preterm infants over the first two years of life. We compared parenting stress in families with preterm infants with control families, while also comparing the stress in mothers to that in fathers. Furthermore, we explored the relationship between parenting stress in the preterm group with identified factors that included the infant's age, medical complications, and parents’ perceived feeding issues after they had been discharged from the hospital. This was an exploratory study with a cross sectional design. Participants included a total of 505 mothers from Tainan, Taiwan; 297 with preterm children (239 mothers, 58 fathers) and 208 with full-term children (181 mothers, 27 fathers). Assessments including the Parenting Stress Index, Neonatal Medical Index and Behavior-based Feeding Questionnaire were used to measure parental distress, infants’ medical complications and parents’ perceived feeding issues, respectively. Results of the study, though not statistically significant, indicated the presence of increased parenting stress in parents of preterm infants as compared to parents of full-term infants. 13.1% of mothers with preterm infants demonstrated total stress levels that warranted clinical intervention. We also found that mothers of preterm infants presented different parenting stress patterns than fathers of preterm infants. Fathers of preterm infants tended to have overall higher stress scores than mothers. On the other hand, mothers of preterm infants tended to report more health related difficulties, more depression, higher social isolation and role restriction, and less support from their spouses, than reported by fathers. Moreover, as time went on, parents with preterm infants continued to experience greater parenting stress than those with full-term infants. Understanding the experiences of parents with preterm children is important for health care providers while interviewing parents for information regarding their children and designing intervention programs to improve children's outcomes.     

The association of major depression, conduct disorder, and maternal overcontrol with a failure to show a cortisol buffered response in 4-month-old infants of teenage mothers.

BACKGROUND: Adolescent pregnancy can be associated with major depression (MD) and conduct disorder (CD). Some infants of adolescent mothers are prenatally exposed to these factors, which may result in heightened risk for perturbations of their stress systems. Between 2 and 4 months, a normal shift occurs in the adrenocortical system in which we observe a marked decrease in infant cortisol response when facing mild stressors. This study aimed to explore whether MD (lifetime, during pregnancy, postpartum), CD, and maternal overcontrol are associated with increased cortisol reactivity in 4-month-old infants of teenage mothers. METHODS: Using arm restraint as a stressor, morning salivary cortisol was taken prestressor and poststressor in 212 infants during a laboratory visit. Major depression and CD were measured with the computerized National Institute of Mental Health Diagnostic Interview Schedule (NIMH-DIS), postpartum depressive mood was measured with the Edinburgh Postnatal Depression Scale, and overcontrol was observed with the CARE-Index. RESULTS: Independent of the predictors, there was a dampened cortisol response. Infants of mothers with lifetime MD and of average to highly overcontrolling mothers showed increased cortisol reactivity. Conduct disorder and cortisol levels were not associated. CONCLUSIONS: Future studies should detect whether the absence of a dampened cortisol response in infants whose mothers have lifetime MD or display overcontrolling parenting is stable over time.     

Influence of selected child characteristics on stress in families of handicapped infants

Parents of 31 handicapped infants were interviewed to determine the extent to which specific kinds of behavior and characteristics of the child were related to the stress reported by mothers. Five characteristics were examined: rate of child progress, responsiveness, temperament, repetitive behavior patterns, and the presence of additional or unusual caregiving demands. All characteristics except rate of progress were significantly related to the amount of stress reported. The only demographic characteristic associated with the amount of stress reported was the number of parents in the home. Single mothers reported more stress than mothers in intact homes.     

Maternal posttraumatic stress response after the birth of a very low-birth-weight infant

OBJECTIVE: For parents, the premature birth of a child represents a traumatic event for which they are poorly prepared. To date, the focus of scientific interest has been on maternal psychological stress responses, such as anxiety and depression, or on appropriate coping mechanisms, whereas only scant attention has been paid to the traumatic aspect of the maternal experience after very low-birth-weight (VLBW) birth. The present study is the first to investigate the posttraumatic stress response of mothers after the birth of a VLBW infant in a prospective longitudinal study. METHODS: Fifty mothers of VLBW infants were examined at four measuring time points (1-3 days pp, 14 days pp and 6 and 14 months pp) with respect to posttraumatic symptoms [Impact of Event Scale (IES-R)], psychiatric diagnosis (SKID I for DSM-IV) and the extent of depression [Beck Depression Inventory (BDI) and Montgomery Asberg Depression Scale (MADRS)] and anxiety [State-Trait Anxiety Inventory (STAI) and Hamilton Anxiety Scale (HAMA)]. The control group comprised a group of 30 mothers after the uncomplicated spontaneous birth of a healthy child. RESULTS: At all four measuring timepoints (except 6 months pp), the mothers of the premature infants recorded significantly higher values for traumatic experience and depressive symptoms and anxiety compared with the controls. In contrast to the mothers in the control group, the mothers of the premature infants displayed no significant reduction in posttraumatic symptoms (IES-total), even 14 months after birth. CONCLUSION: The results indicate that the situation of a mother who has given birth to a VLBW infant is a complex, with long-term traumatic event necessitating ongoing emotional support extending beyond the period immediately after the birth.     

Laughter elevates the levels of breast-milk melatonin

OBJECTIVE: Patients with atopic eczema (AE) often complain of sleep disturbance. Melatonin is involved in sleep, and the levels of blood melatonin in patients with AE are decreased in comparison to healthy subjects. However, the levels of breast-milk melatonin had only been reported in healthy subjects. Laughter increased natural killer cell activity in blood and free radical-scavenging capacity in saliva in healthy subjects. Thus, the effect of laughter on the levels of breast-milk melatonin was studied in mothers with AE. Moreover, the effect of feeding with breast milk after laughter on allergic responses in infants was studied. METHODS: Forty-eight infants aged 5-6 months were enrolled. All of the infants had AE and were allergic to latex and house dust mite (HDM). Half (n=24) of the mothers of these infants were patients with AE, while another 24 mothers were healthy subjects. The mothers viewed either an 87-min humorous DVD (Modern Times, featuring Charlie Chaplin) or an 87-min nonhumorous weather information DVD at 2000 h. After viewing, breast milk was collected sequentially from 2200, 2400, 0200, 0400 to 0600 h. The levels of breast-milk melatonin were measured. In addition, skin wheal responses to HDM and histamine were studied in infants. RESULTS: Laughter caused by viewing a humorous DVD increased the levels of breast-milk melatonin in both mothers with AE and healthy mothers. In addition, allergic responses to latex and HDM of infants were reduced by feeding with breast milk after laughter of mothers with AE or of healthy mothers. CONCLUSION: Laughter increased the levels of breast-milk melatonin in both mothers with AE and healthy mothers, and feeding infants with increased levels of melatonin-containing milk reduced allergic responses in infants. Thus, laughter of mothers may be helpful in the treatment of infants with AE.     

Impact of a prenatal cognitive-behavioral stress management intervention on salivary cortisol levels in low-income mothers and their infants

Recent findings suggest that elevated stress levels during the pre- and postpartum period are related to poor maternal and infant health outcomes; yet, few studies have prospectively examined the efficacy of stress management interventions on regulating stress levels among mothers and their infants. The current study examined whether a prenatal cognitive behavioral stress management (CBSM) intervention would be effective in regulating salivary cortisol (a biological marker of stress) and self-reported stress levels among mothers and their infants at six and 18 months postpartum, relative to two control groups. Our sample was comprised of predominantly Spanish-speaking, low-income women (80%; mean age=25±5 years) who were screened for depression during their second trimester of pregnancy (M=16±5 weeks of gestation). Women at high risk for depression [i.e., having either a past history of major depression or current elevated symptoms of depression (≥16 on CES-D)] were randomized to either a CBSM group (n=24) or a usual care (UC) group (n=33), while a low risk comparison (LRC) group (n=29) was comprised of women not meeting either depression criteria. ANCOVA analyses demonstrated that: (1) infants of women in the CBSM and LRC groups had significantly lower cortisol levels than infants of women in the UC group at six months postpartum (p<.001); and (2) women in the CBSM group had lower cortisol levels than women in the UC group at 18 months postpartum (p<.01). These results suggest that prenatal CBSM interventions may be efficacious in regulating biological markers of stress among mothers and their infants, thereby decreasing their risk for developing health complications over time.     

The relationship of maternal and child HIV infection to security of attachment among Ugandan infants

This study was designed to examine the relationship of maternal and child human immunodeficiency virus (HIV) infection to the security of attachment of Ugandan infants. The attachment patterns of two groups of Ugandan mother-infant pairs: 35 HIV-positive mothers and their infants and 25 HIV-negative mothers and their infants were compared. We tested the hypothesis that infants of HIV-positive mothers would demonstrate less secure attachment as measured by the Waters Attachment Q-set than infants of HIV-negative mothers. No differences were found in the security of attachment of infants of HIV-positive versus HIV-negative mothers. Infants of HIV-positive mothers with Acquired Immunodeficiency Syndrome (AIDS) were less securely attached than infants of mothers without AIDS. These findings underscore the relationship of infant security of attachment to maternal HIV infection in the presence of AIDS-related symptoms but not to asymptomatic maternal HIV infection.     

Self-reported depressive symptoms and parental stress in mothers and fathers who bring their infants to an infant mental health clinic

Background: The parental functioning and its influence upon infant mental health development have been extensively studied but there are few clinical studies investigating less severe psychiatric problems among mothers and fathers in the same family. Aim: This study focuses on the emotional well-being of mothers and fathers who bring their infants to an Infant Mental Health Clinic. Methods: The studied sample is comprised of 63 families with 0–47-month-old infants where the mothers completed the Center for Epidemiological Study—Depression Scale (CES-D), including 43 families in which the CES-D was completed by both parents. In 44 families, the mothers also filled in the Swedish Parental Stress Questionnaire (SPSQ), including 32 where the SPSQ was completed by both parents. The children were independently classified with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC 0–3). Results: Altogether, 54% of the mothers and 11% of the fathers reported depressive symptoms above the CES-D clinical cut-off. Self-rated depressive symptoms and parental stress were strongly related. The mothers' self-rated depressive symptoms were associated with the severity of their infant's problems, but the association was not specific to the DC 0–3 Axis I classification. The mothers' stress level was marginally related to DC 0–3 Axis II relationship classification. Conclusion: The results indicate that the inclusion of systematic parental self-ratings in infant mental health assessments could add clinical information facilitating the planning of family oriented interventions.     

Borderline personality disorder, mother-infant interaction and parenting perceptions: preliminary findings

OBJECTIVE: Parents diagnosed with borderline personality disorder (BPD) are likely to find the emotional aspects of parenting challenging. Research into the difficulties that these parents experience, however, is lacking. The aims of the present study were to (i) gain an understanding of the interactional patterns of mothers with BPD and their infants and (ii) to explore the parenting perceptions of mothers with BPD. METHOD: Two groups of mother-infant dyads were recruited: mothers with BPD and their infants; and community mothers and their infants. Groups were compared on mother-infant interaction patterns and on maternal self-perceptions of parenting. RESULTS: Mothers with BPD were found to be less sensitive and demonstrated less structuring in their interaction with their infants, and their infants were found to be less attentive, less interested and less eager to interact with their mother. Furthermore, mothers with BPD reported being less satisfied, less competent and more distressed. CONCLUSIONS: Early intervention needs to be provided to mothers with BPD to promote maternal sensitivity and maternal perceptions of competence.