Maternal Responsiveness in Mothers of Preterm Infants

This longitudinal study of maternal responsiveness included a sample 23 mothers of preterm infants. The mothers completed questionnaires at three intervals: 2 weeks postpartum, 2 weeks after the infant's discharge from the neonatal intensive care unit, and 3 months postpartum. Factors that have a potential effect on maternal responsiveness including postpartum depression, social support, stressors, self-esteem, maternal well-being, and maternal attitude were also examined. There were no significant changes in these variables or in maternal responsiveness over time. Social support and self-esteem were found to have a significant positive relationship with maternal responsiveness. Stressors had a significant inverse relationship with maternal responsiveness. There were no significant relationships between maternal well-being, postpartum depression, and maternal attitude about being a mother and maternal responsiveness. The findings suggest that although maternal responsiveness may be stable over time, it may be associated with other characteristics of the mother that need to be assessed.     

Pharmacodynamic profile of short-term readministration of abciximab in healthy subjects

Objective The purpose of the study was to establish a rebolus regimen for abciximab that restores pharmacologic glycoprotein (GP) IIb/IIIa receptor blockade within a short time frame (up to 48 hours) after completion of an initial treatment. Methods and Results The study was a single-center, nonrandomized, open-label dose escalation trial in healthy volunteers (n = 30). Each subject received a 0.25 mg/kg bolus and a 0.125 μg/kg per minute infusion of abciximab, followed by incremental bolus doses of the agent at 15-minute intervals up to 48 hours (10 per group) after completion of the infusion, (maximal cumulative rebolus dose of 0.25 mg/kg). Pharmacodynamic measurements (GP IIb/IIIa receptor blockade, turbidimetric and whole blood platelet aggregation with use of a rapid platelet function assay [RPFA]) were obtained at periodic intervals during and after administration of the abciximab bolus and infusion. At the time of the first rebolus, pharmacodynamic measurements were attained immediately before administration of each rebolus and 15 minutes after the last rebolus dose. In subjects who received reboluses 12 hours after infusion, a cumulative dose of 0.05 mg/kg restored >80% blockade of GP IIb/IIIa receptors and >80% inhibition of turbidimetric (5 and 20 μmol/L adenosine diphosphate) and RPFA aggregation in 10 of 10 subjects. At 24 hours after treatment, a cumulative abciximab bolus dose of 0.1 mg/kg restored >80% blockade of all 4 pharmacodynamic measurements in 10 of 10 subjects. At 48 hours after treatment, a cumulative bolus dose of 0.15 mg/kg restored >80% blockade of all 4 pharmacodynamic measurements in 10 of 10 subjects. Conclusions A fraction of the bolus of abciximab restored pharmacologic (>80%) GP IIb/IIIa receptor blockade when readministered at various postinfusion time points. These observations suggest that in the setting where acute readministration of abciximab is required less than a full bolus dose of the agent is warranted. (Am Heart J 2002;143:87-94.)     

Fetal brain sparing is associated with accelerated shortening of visual evoked potential latencies during early infancy

OBJECTIVE: Our purpose was to assess the effects that fetal growth restriction exerts on the myelination of the developing brain. STUDY DESIGN: Fetal haemodynamic centralization, an adaptive strategy to growth restriction caused by placental insufficiency, was determined by Doppler ultrasonography. Infants with a raised ratio between umbilical artery pulsatility index and cerebral artery pulsatility index are severely growth restricted. Visual evoked potentials give information on the degree of brain myelination. Shortening of visual evoked potential latencies is a normal feature of myelination. In a consecutive series of 105 neonates, visual evoked potentials were recorded at the corrected ages of 6 months and 1 year. Correction for possible confounders, such as cranial ultrasonographic findings, gestational age, and head circumference, was performed. RESULTS: At 6 months, infants with a raised umbilical artery/cerebral artery pulsatility index ratio have shorter visual evoked potential latencies. Opposite of neonates with a normal umbilical artery/cerebral artery ratio, they show no postnatal maturational shortening of visual evoked potential latencies. CONCLUSION: Accelerated neurophysiologic maturation, found in infants with a high umbilical artery/cerebral artery ratio, might be the result of a beneficial adaptive process to severe fetal growth restriction. (Am J Obstet Gynecol 1996;175:1569-75.)     

Microbiology of mandibular third molar pericoronitis: Incidence of β-lactamase-producing bacteria

Objectives. The purpose of this study was to evaluate the predominant flora associated with pericoronitis in third molars and to investigate the presence of β-lactamase-producing strains. Study design. The third molars in 26 adults were evaluated by cultures with nonselective media and with selective media containing amoxicillin, pristinamycin, spiramycin, metronidazole, and spiramycin plus metronidazole. Results. In the majority of cases (19/26), the flora found in an anaerobic atmosphere predominated. Obligate anaerobes were present in 21 of the 26 samples. The bacteria most commonly detected were α-hemolytic streptococci (26/26) and the genera Prevotella (15/26), Veillonella (15/26), Bacteroides (9/26), and Capnocytophaga (9/26). Amoxicillin and pristinamycin were the most active in reducing the anaerobic cultivable counts. β-Lactamase-producing strains were detected in 9 samples and were mostly bacteria of the genera Prevotella, Staphylococcus, and Bacteroides. Conclusion. These results highlight (1) the diversity of the microflora associated with pericoronitis and the importance of the anaerobic flora and (2) the existence of selection pressure related to the use of β-lactams that may culminate in failure of prescribed penicillins. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:655-9)     

Identification of SAF-2, a novel siglec expressed on eosinophils, mast cells, and basophils

Background: Eosinophils, basophils, and mast cells are believed to be the central tenet cells in allergic conditions including allergic rhinitis, asthma, and eczema. The molecular mechanisms underlying the recruitment of these cells to sites of allergic inflammation are poorly understood. Objectives: Our aim was to identify a common adhesion molecule that could potentially be responsible for mediating the recruitment of the allergic cell types to the lungs and other sites of allergy. Methods: We have cloned a sialoadhesin molecule from a human eosinophil library with the use of expressed sequence tag technology and characterized its expression on allergic cells by the use of flow cytometry and specific mAbs. Results: With the use of expressed sequence tag sequencing, we have identified a novel siglec molecule, SAF-2. SAF-2 has homology with other sialoadhesin family members (CD33 and siglec-5) and belongs to a subgroup of the Ig superfamily. SAF-2 is a 431–amino acid protein composed of 3 Ig domains with a 358–amino acid extracellular domain and a 47–amino acid tail. SAF-2 is highly restricted to eosinophils, basophils, and mast cells. Antibodies to SAF-2 do not modulate Ca⁺⁺ mobilization or chemotaxis of human eosinophils induced by eotaxin. Conclusion: SAF-2 is a highly restricted sialoadhesin molecule, which may be useful in the detection and/or modulation of allergic cells. (J Allergy Clin Immunol 2000;105:1093-1100.)     

Predicting variations to missed nursing care: A three‐nation comparison

Aims

To measure and model Australian, Cypriot and Italian nurses’ beliefs about what care is missed and how frequently it occurs within their settings.

Background

This study expands on previous MISSCARE research but now applies and predicts missed care within three countries.

Methods

Multivariate analysis was performed to estimate 1,896 nurses’ consensus scores about missed care activities based on Alfaro‐Lefevre's conceptual framework of care priorities.

Results

Five latent variables have direct predictor effects on missed care frequencies. Another four variables including the nurses’ age, highest qualifications, absenteeism rate and workplace type, contributed to explaining the overall variance of missed care scores. The nurses’ gender had no influence on missed care.

Conclusion

Cross country comparisons of missed nursing care allow for a more refined identification of strategies for remediation for both managers and clinicians.

Implications for Nursing Management

Reliable consensus estimates about the types and frequencies of missed care can be scaled with variables identified to predict missed care across three different countries. Comparative international studies build on the foundations for understanding missed care in terms of nursing practices, policies and related social policies.