Predictors of Maternal Responsiveness

PURPOSE: To explore maternal responsiveness in the first 2 to 4 months after delivery and to evaluate potential predictors of maternal responsiveness, including infant feeding, maternal characteristics, and demographic factors such as age, socioeconomic status, and educational level. DESIGN AND METHODS: A cross-sectional survey design was used to assess the variables of maternal responsiveness, feeding patterns, and maternal characteristics in a convenience sample of 177 mothers in the first 2 to 4 months after delivery. The 60-item self-report instrument included scales to measure maternal responsiveness, self-esteem, and satisfaction with life as well as infant feeding questions and sociodemographic items. An online data-collection strategy was used, resulting in participants from 41 U.S. states. FINDINGS: Multiple regression analysis showed that satisfaction with life, self-esteem, and number of children, but not breastfeeding, explained a significant portion of the variance in self-reported maternal responsiveness scores. In this analysis, sociodemographic variables such as age, education, income, and work status showed little or no relationship to maternal responsiveness scores. CONCLUSIONS: This study provides additional information about patterns of maternal behavior in the transition to motherhood and some of the variables that influence that transition. Satisfaction with life was a new predictor of maternal responsiveness. However, with only 15% of the variance explained by the predictors in this study, a large portion of the variance in maternal responsiveness remains unexplained. Further research in this area is needed.     

Autoregressive analysis of cardiac RR intervals in preterm and full-term infants

For the purpose of obtaining information on the maturation process of the autonomic nervous system in pre- and full-term infants, polygraphs were recorded during sleep from a total of 52 appropriate-for-dates infants at a conceptional age of 28–41 weeks. The 104 RR interval time series was calculated by auto-regressive (AR) and component analysis. Histograms of damping frequencies obtained were divided into two frequency bands: low frequency fluctuations (LF) of less the 0.1 cycle/beat (c/b) and high frequency fluctuations (HF) of more than 0.15 c/b. Total power and LF power decreased with increases in the conceptional age or postnatal age at a significance level of 0.01, respectively. In addition, the HF amount of bio-informing activity increased (P< 0.001) and the damping time of HF also increased (P <0.01). From these results, it was speculated that the activity of the sympathetic system decreases with increases in conceptional or postnatal age. It was also speculated that increased regularity and oscillatory duration in HF might be caused by the development of the reciprocal response of respiration to heart rate variation.     

Glial cell line-derived neurotrophic factor (GDNF) gene expression in the human brain: A post mortem in situ hybridization study with special reference to Parkinson's disease

Summary Glial cell line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor for dopaminergic neurons. Since dopaminergic neurons degenerate in Parkinson's disease, this factor is a potential therapeutical tool that may save dopaminergic neurons during the pathological process. Moreover, a reduced GDNF expression may be involved in the pathophysiology of the disease. In this study, we tested whether altered GDNF production may participate in the mechanism of cell death in this disease. GDNF gene expression was analyzed by in situ hybridization using riboprobes corresponding to a sequence of the exon 2 human GDNF gene. Experiments were performed on tissue sections of the mesencephalon and the striatum from 8 patients with Parkinson's disease and 6 control subjects matched for age at death and for post mortem delay. No labelling was observed in either group of patients. This absence of detectable expression could not be attributed to methodological problems as a positive staining was observed using the same probes for sections of astroglioma biopsies from human adults and for sections of a newborn infant brain obtained at post-mortem. These data suggest that GDNF is probably expressed at a very low level in the adult human brain and its involvement in the pathophysiology of Parkinson's disease remains to be demonstrated. GDNF may represent a powerful new therapeutic agent for Parkinson's disease, however.     

极低出生体重儿转运过程中的护理

目的探讨极低出生儿体重儿转运过程中的有效护理措施，降低其死亡率。方法通过转运系统将基层医院32例极低出生体重儿转运至新生儿重症监护病房治疗，具体措施包括现场抢救，应用肺泡表面活性物质，途中连续监护和治疗。结果极低出生体重儿32例均成功转运，治愈出院13例，死亡19例，无一例途中死亡。结论全程监护，尽早转运及应用固尔苏是转运成功及降低极低出生体重儿死亡率的关键。     

婴儿培养箱基本性能研究与改进

根据对婴儿培养箱多年的临床使用与维修体会,阐述了婴儿培养箱基本性能要求,并指出现行的此类设备存在的问题,及具体改进方法。     

Follow up of growth and steroids in premature adrenarche

In a follow up study of 34 patients with premature adrenarche we examined serum adrenal androgen levels and growth. The majority (28/34) showed an upward bend in the growth curve which, at the mean age of 2.3 years, preceded other signs of adrenarche on average by 3.8 years. Pubertal growth spurt was missing or reduced in 50% of the patients (8/16), however, final height did not differ from that expected from parental heights. Adrenal androgens did not remain elevated at adolescence. The mean age at menarche for all the girls was 0.5 years younger than in the general population.Conclusion Our findings imply that premature adrenarche may start earlier than previously recognized. Compared to ordinary growth these children seen to use a greater part of their potential for adult height already at that early age.     

Deleterious effects of the prone position in the full-term infant throughout the first year of life

Summary Seventy-one first-born infants who had been nursed in prone position since birth, were referred for motor assessment at 3 months, 5 months and 9 months. All infants were administered the same checklist of motor items, based on the Amiel-Tison Infant Neurological Evaluation and on the Brunet-Lézine Developmental Psychomotor Scale. Abnormalities in muscular shortening and delay in motor skills were found. These findings are critical as regards environmental influences on postural development, continuities in motor development and issues of early primary prevention. Early identification and follow-up programmes, including frequent changes in posture, are suggested in order to avoid abnormalities of motor behaviour and subsequently in postural patterns.     

雾化吸入对新生儿肺炎患儿血氧饱和度的影响

采用动脉血氧饱和度仪对５２例新生儿肺炎患儿，在雾化吸入治疗过程中的动脉血氧饱和度（ＳａＯ２）进行了监测，对比了吸氧与否对ＳａＯ２改变的影响。结查表明：与基础值比较，雾化吸入时患儿的ＳａＯ２显著下降（Ｐ＜０．０１），而雾化吸入同时吸氧者ＳａＯ２无明显变化（Ｐ＞０．０５），但两者比较具有显著性差异（Ｐ＜０．０１）。结果提示雾化吸入可使新生儿肺炎患儿ＳａＯ２下降；同时吸氧，对防止ＳａＯ２的下降有一定作用。     

极低体质量近存活期分娩儿一例的出生后早期管理

近存活期分娩（PVB）儿各组织系统发育极不成熟,易发生各种器官功能损害和并发症,预后常不佳。目前关于PVB儿出生后早期管理的报道不多,诸多尚待解决的问题仍是围产医学所面临的挑战。经有效的新生儿复苏和呼吸循环支持、积极的营养支持和喂养、防治感染、内分泌和代谢性疾病管理、积极处理早产儿相关并发症,以及发育支持护理、家庭参与式护理等一系列个体化管理和精细化护理,四川省医学科学院·四川省人民医院成功救治了1例胎龄23周,出生体质量（BW）为450 g的PVB儿。本文通过总结1例PVB儿的出生后早期管理,并结合文献复习进行归纳总结,以期为提高BW<500 g的PVB儿存活率并获得良好预后提供经验及借鉴。