The estimation of fetal weight by computer-assisted analysis

The need for a quick and easy method for estimating fetal weight in utero has been clearly established. Estimates by abdominal palpation and fetal hormone production have proved to be of limited value. Eighty-five patients, ranging from 17 to 41 weeks' gestation, were ultrasonically scanned within 48 hours of delivery. Statistical analysis and multiple multivariant linear regressions were performed employing the BMD statistical packages. Our results show that birth weight is a logarithmic function of fetal body parameters and that the abdominal circumference has the single best correlation with the log₁₀ birth weight. Our best linear regression with the use of two fetal dimensions (abdominal circumference and biparietal diameter) had a standard deviation of 106 grams per kilogram fetal weight. Since this derived formula is very cumbersome to manipulate, tables have been prepared with computer assistance to read the estimated fetal weight directly. Prospective estimates in 32 cases of both normal and pathologic gestations have proved to be within our expected accuracy.     

Cetiedil inhibition of calmodulin-stimulated enzyme activity

Cetiedil, an in vitro anti-sickling agent, inhibited calmodulin-stimulated cyclic 3':5'-nucleotide phosphodiesterase (EC 3.1.4.17) and Ca2+-ATPase (ATP phosphohydrolase, EC 3.6.1.3) activities. The drug had no effect on basal enzyme activities in the absence of calmodulin. The inhibition of phosphodiesterase was competitive with respect to the concentrations of both cAMP and calmodulin. Cetiedil did not inhibit calmodulin-stimulated enzyme activities by acting as a calcium chelator, since increasing the concentration of calcium did not reverse the inhibitory effect.     

Postnatal physiologic hypercholemia in both premature and full-term infants.

Previous studies have shown that bile salt concentrations in human blood taken from the placenta at birth of term infants are in the range found in adults. A 125I-radioimmunoassay procedure and capillary gas liquid chromatography-mass spectrometry have been used in this investigation to measure serum bile salt concentrations in premature and normal term infants. It was found that the serum bile salt concentration in samples taken at birth in premature infants were also similar to that of adults. In the week after birth the serum bile salt concentration rose four- to sevenfold in each of the infant groups. The increase was independent of gestational age and the "health" of the child. A similar increase was observed in term infants. Thus, hypercholemia is physiologic in newborn infants. In conjunction with other abnormalities of the enterohepatic circulation of bile salts there are profound implications in the newborn for the metabolism and excretion of those endogenous and exogenous substances that are dependent on the secretion of bile salt by the liver. In addition, speculations concerning the role of parenteral nutrition in the induction of cholestasis in premature infants should be made with caution.     

Parental directiveness and responsivity toward young children with complex communication needs

Purpose: The aim of the present study was to determine if parent responsiveness to their children with complex communication needs (CCN) during naturalistic play changed over an 18-month period and determine if any such changes were influenced by the child’s overall level of receptive and expressive language development, motor development or differing play contexts. This longitudinal information is important for early intervention speech-language pathologists and parents of children with developmental disabilities for whom the use of parent-directed responsivity interventions may be encouraged.

Method: Over an 18-month period, 37 parents of young children who had physical and/or neurological disabilities participated in three home-based parent–child play episodes. Videotapes of each play episode were extracted and coded.

Result: Results indicated parents who were initially responsive showed a significant tendency to continue to be so. Early on, parents were significantly more likely to be directive during object play than social play and significantly more likely to interact responsively during social play than object play.

Conclusion: Parents of children with developmental disabilities were not consistently less responsive to their children based on motor or language capabilities. Previous reports of higher parental directiveness with children who have developmental disabilities may be attributable to object-based play interactions.     

USING A COGNITIVE BEHAVIORAL FRAMEWORK TO TRAIN STAFF SERVING INDIVIDUALS WHO EXPERIENCE CHRONIC HOMELESSNESS

Training in evidence‐based practices may better prepare providers to address the effect of behavioral health concerns on chronic homelessness. Through the Beck Initiative, a community–academic partnership, case managers (n = 19) were selected to incorporate a cognitive‐behavioral therapy (CBT) framework into services for chronic homelessness at seven sites in Philadelphia, PA. Details of the training components and development are presented. This training program demonstrated feasibility within these low‐demand shelter settings (79% completed training, 10% left employment during training, 10% did not complete). Feedback measures indicated positive feedback regarding acceptability, usefulness, and quality of training. Planned discharges from the shelters were significantly more frequent in the 6 months posttraining compared with the 6 months before training. The CBT framework shows early promise for improving services for people experiencing chronic homelessness. This program also demonstrates the benefit of involving community stakeholders and academic partners to address one aspect of chronic homelessness.     

The early establishment of Streptococcus mutans in the mouths of infants

The colonization of Strep. mutans in infants was studied using a selective medium. The organism was not detected in 91 normal predentate infants, but was detected in two out of ten predentate cleft palate infants with acrylic obturators. In infants with only erupted primary incisors, the organism was detected in plaque samples from 9 of 40 subjects. Serological characterization of 66 Strep. mutans isolates from nine mother-child pairs revealed the c serotype to be the most common. In addition one b, two d, and one E serotype were isolated from the mothers. All isolates from infants were of the c serotype. Subsequent samples were obtained in the case where the b serotype was detected. Strains of this serotype were isolated from both mother and infant.     

Clinical outcomes for Early Childhood Caries (ECC): the influence of salivary mutans streptococci levels.

AIM: To assess the relationship between clinical outcomes for children treated for Early Childhood Caries (ECC) and salivary mutans streptococci (MS) levels. STUDY DESIGN AND METHODS: The study cohort consisted of 79 children (42 males, 37 females) treated for ECC, aged from 2.3 to 7.3 years at time of entry. Whole non-stimulated saliva samples were obtained from each subject prior to dental surgery and at 6 mths post dental surgery, by saturating a cotton swab in the saliva pooled in the floor of the mouth. Samples were placed into PBS on ice and processed within 2 hours. Samples were sonicated, serially diluted and plated onto MSB and SBA agar plates, then incubated 48 hours anaerobically; SBA plates were incubated an additional 24 hours aerobically. The MS level in each sample was expressed as a percentage of the total cultivable flora. The cohort was evaluated for new caries lesions at 6 months post dental surgery. Relapse was defined as the presence of new smooth surface caries lesions. STATISTICS: Comparisons between Relapse (R) and Non-Relapse (NR) groups with respect to mutans streptococci levels were performed using Wilcoxon tests. Within group comparisons were performed using Wilcoxon signed-rank tests. RESULTS: 57 children (72%) returned for the 6 months examination and 21 of these subjects (37%) relapsed. No statistically significant difference in median salivary MS levels existed between the R (0.20%) and NR (0.033%) groups at baseline (p=0.647) or at 6 months post dental surgery (R=0.03%; NR=0.01%; p=0.273). A statistically significant difference between baseline and 6 months post dental surgery was noted in the median salivary MS level within the R group (p=0.0007) and within the NR group (P<0.0001). CONCLUSIONS: The relapse rate (37%) was high and rapid for children treated for ECC. Dental surgery resulted in a statistically significant reduction in salivary MS reservoirs for children treated for ECC. However, this did not translate into acceptable clinical outcomes.