Meconium peritonitis: prenatal sonographic findings and their clinical significance

Ultrasonographic (US) findings were correlated with clinical outcome in seven cases of meconium peritonitis detected with prenatal US during a 2-year period. Nineteen previously reported cases were also reviewed. US findings included intraabdominal calcifications (n = six cases), fetal ascites (n = 3), echogenic ascites without calcifications (n = 1), bowel dilatation (n = 2), and polyhydramnios (n = 5). Following delivery, six infants were still alive after a mean follow-up of 13 months (range, 6-26 months); the seventh died of hydrocephalus. Of the six, four required surgical correction of a small-bowel perforation and two did not. All six are thriving, and none has yet been found to have cystic fibrosis. In the 19 previously reported cases, there were only two cases of cystic fibrosis, neither with intraabdominal calcifications. The presence of calcifications was significantly associated with causes other than cystic fibrosis. Prenatally diagnosed cases of meconium peritonitis are associated with cystic fibrosis less frequently than previous studies suggest.     

Lactation Duration: Influences of Human Milk Replacements and Formula Samples on Women Planning Postpartum Employment

Objective: To examine the influences of i hospital administration of breast milk replacement and receipt of formula samples on lactation duration among women planning postpartum employment.
Design: Prospective design.
Setting: Telephone interviews conducted prenatally and at 6 weeks, 3 months, and 6 months postpartum.
Participants: Sixty-nine participants entered the study; 53 completed all scheduled interviews.
Main Outcome Measures: Incidence and type. of in-hospital human milk replacement, incidence ar sources of formula samples, incidence of breastfeeding at 6 weeks postpartum, and duration of lactation.
Results: During hospitalization, 19% of in fants received formula; the incidence of breastfeeding at 6 weeks and duration of breastfeeding were significantly shorter in these infants compared with infants who were not fed formula. Fifty-nine percent of participants received formula samples from the hospital, 30% received samples from a physician's office, and 51% received samples by mail Receipt of formula samples by mail was associate with reduced incidence of breastfeeding at 6 weeks and shortened duration of lactation.
Conclusions: Early formula feeding and receipt of formula samples by mail may be barriers I lactation in women employed outside the home.     

A Low-Fat Intake and Greater Activity Level are Associated With Lower Weight Regain 3 Years After Completing a Very–Low-Calorie Diet

Objective To examine the roles of diet, exercise, and lifestyle factors in determining long-term weight regain after weight loss with a very–low-calorie diet (VLCD).Subjects Twenty-seven of 38 women who lost weight with a VLCD.Design Graduates of a weight loss intervention study returned for follow-up 3 years after program completion. Percentage of initial weight loss that was regained was correlated with subjects’ fat intake (assessed via 7-day food records and a Diet Habit Survey), energy intake (assessed via 7-day food records), activity level and lifestyle factors (assessed via questionnaires) that are supportive of weight loss maintenance.Statistical analyses performed Regression analysis was used to assess the relationship of weight regain with fat intake, activity level, and energy intake. Contingency table analysis was used to assess the association between weight regain and lifestyle factors.Results Subjects followed experienced a −20.7 kg±9.2 kg (−19.2%±7%) (mean±standard deviation) weight change during the original VLCD program and a 13.9 kg±11.3 kg (76.6%±52.1%) weight change 3 years post-VLCD. Fat intake, assessed by a 7-day food diary, was positively correlated with weight regain at 3 years (r=0.66, P=.0004). Less weight regain was also seen with a lower percent fat intake as reflected by a higher Diet Habit Survey score (r=−0.55, P=.004). Women with the lowest tertile of reported fat intake (<25% of energy) from the Diet Habit Survey regained the least amount of weight (P=.05). Activity level was negatively correlated with weight regain (r=−0.53, P=.005). After correction for multiple comparisons, there was no association between total energy intake and weight regain. Lifestyle factors were also not associated with weight regain.Applications/conclusions Identifying strategies to maintain weight loss is crucial because of the negative health effects and increasing prevalence of obesity. For women who have lost weight on a VLCD, limiting dietary fat intake and maintaining physical activity are both important factors for the prevention of weight regain. To promote better weight loss outcomes, registered dietitians should help clients who have lost weight limit their fat intake to less than 30% of energy and encourage high activity levels. J Am Diet Assoc. 2002;102:1252–1256.