Determinants of newborn feeding in maternity hospital care. Part II: factors associated with exclusive breast feeding

OBJECTIVES: To study the effects of newborn status and hospital practices on exclusive breast-feeding in a maternity ward. DESIGN: National survey conducted in January 1995 in 427 hospitals. MATERIALS AND METHODS: Data on 11,422 newborns obtained from hospital staff. Statistical analysis was performed using odds ratios (OR), population attributable risks (PAR%) and logistic regression method. RESULTS: The most important factors for supplementation were: caesarean section (OR = 5.3; PAR = 19.0%), first breastfeeding later than 2 h after birth (OR = 5.2; PAR = 41.3%), mother and newborn separation longer than 1 h/24 h (OR = 3.4; PAR = 44.9%). Logistic regression analysis showed that first feeding in 2 hours is the main prognostic factor for exclusive breastfeeding in a maternity ward. CONCLUSIONS: Changes in hospital practices increase the proportion of exclusively breastfeeding infants during stay in the maternity ward.     

Sandifer's syndrome in a child with asthma and cerebral palsy

Gastroesophageal reflux is a common problem in infancy and childhood. However, it may be overlooked as a cause or complication of respiratory disease and/or neurobehavioral problems. In this report of a 5-year-old child with cerebral palsy, severe developmental delay, and asthma, Sandifer's syndrome was diagnosed after she was found to have gastroesophageal reflux disease (GERD). Awareness of GERD and Sandifer's syndrome may spare neurologically impaired children from persistent symptoms and delayed appropriate treatment.     

BAL from two different lung segments indicated by high resolution computed tomography (HRCT) in patients with sarcoidosis. II. The role of T gamma delta lymphocytes (T gamma delta)

The aim of the study was to evaluate the role of lymphocytes T gd in sarcoidosis by estimation of T gd cells in double BAL (2 x 120 ml) from two different lung segments: with the most (s.A) and with the least (s.B.) extensive involvement evaluated by high resolution computed tomography (HRCT) and in peripheral blood. Examined group consisted of 28 sarcoid patients with homogeneous, regular distribution of nodular opacities in conventional chest X-ray (14 F, 14 M aged 19-54). Twelve patients showed homogeneous distribution of HRCT changes (RD) in lung parenchyma and 16 showed nonhomogeneous distribution of HRCT changes (ND) with domination of pathological changes in upper lobes. Eleven healthy volunteers served as controls. Lymphocytes T gd were estimated by flow-cytometry. In peripheral blood of patients with sarcoidosis the mean value of T gd lymphocytes (4.75%) did not differ from control group (5.3%). In all patients the mean values of T gd percentage in BAL from s.A (1.7 + 1.0%) and in BAL from s.B (2.1 + 1.5%) were significantly lower (p < 0.01) than the mean value in peripheral blood (4.75 + 2.4%) and were significantly lower than mean value of T gd cells in BAL from s.B bis (4.2 + 2.7%). Among subgroups ND and RD we did find any significant differences between values of T gd in BAL form s.A and s.B. Our results suggest minimal role of T gd lymphocytes in sarcoid pathogenesis.     

Assessment of selected B cells populations in the workers of X-ray departments

Objectives

Workers of X-ray departments are occupationally exposed to long-term low levels of ionizing radiation (LLIR), which may affect their humoral immunity. The aim of the study was to assess the influence of LLIR on the number and proportion of B cells (CD19+), B1 cells (CD5+CD19+) and memory B cells (CD27+CD19+) in peripheral blood of such workers.

Materials and Methods

In the study group of 47 X-ray departments workers and the control group consisting of 38 persons, the number and percentage of CD19+, CD5+CD19+, CD27+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were assessed using flow cytometry. Additionally, the study group was divided into 2 groups by the length of employment below and over 15 years and analysis adjusted for age and smoking habit was performed.

Results

The total number of CD19+ cells showed significant increase in the group of workers in comparison with the persons from the control group, whereas the percentage of CD5+CD19+ cells as well as CD27+CD19+/CD19+ and CD5+CD19+/CD19+ cell ratios were lower. Percentage, number of CD5+CD19+ cells and CD5+CD19+/CD19+ cell ratio were significantly lower in the workers with length of employment longer than 15 years in comparison with those employed below 15 years. Moreover, we found positive associations between the number of CD19+ cells and employment as well as smoking habit, whereas the number of CD5+CD19+ cells was positively associated with cigarette smoking alone. Percentage of CD5+CD19+ cells as well as CD5+CD19+/CD19+ and CD27+CD19+/CD19+ cell ratios were negatively correlated with employment.

Conclusions

The study suggests association between the suppressive influence of low level ionizing radiation on circulating in peripheral blood, especially of B1 cells as well as of memory B cells, in workers of X-ray units, which is adverse in relation to microbiological threat.     

Comparison between the disease-specific Airways Questionnaire 20 and the generic 15D instruments in COPD

Background  

Given that the assessment of health-related quality of life (HRQoL) is an essential outcome measure to optimize chronic obstructive pulmonary disease (COPD) patient management, there is a need for a short and fast, reliable and valid instrument for routine use in clinical practice. The objective of this study was to analyse the relationship between the disease-specific Airways questionnaire (AQ20) and the generic 15D health-related quality of life (HRQoL) instrument simultaneously in a large cohort of patients with COPD. We also compare the HRQoL of COPD patients with that of the general population.