RESUMEN
The purposes of this study are (1) to evaluate the practice of red blood cell transfusions in very low birth weight (VLBW) infants (between 501 to 1500 g) during the postsurfactant era of the 1990s; and (2) to evaluate if there is a decreasing trend in red cell transfusions in the 1990s. Database and medical records of VLBW infants admitted to the neonatal intensive care unit (NICU) between January 1990 and December 1995 at Scott & White Clinic, Temple, Texas, were reviewed. Five hundred twenty-seven infants were admitted to the NICU, excluding 5 infants that were transferred out for possible cardiac surgery or for other reasons. Fifty one (9.7%) of these infants died prior to discharge. Hence, data from 476 survivors were reviewed for red blood cell (RBC) transfusions. Transfusions were given at the discretion of the attending neonatologist. None of the infants received erythropoietin. Of the 476 infants, 289 (61%) received RBC transfusions during the hospital stay, with 2.7+/-3.6 transfusions per infant with a volume of 40.5+/-50.4 mL/kg. Smaller infants required significantly more transfusions compared to larger infants when divided into 250-g subgroups. No statistically significant difference was noted in the number of RBC transfusions per infant or number of infants transfused during the 6-year period from year to year. We conclude that VLBW infants in the 1990s postsurfactant era required 2.7 RBC transfusions per infant, on average, with the smallest infants requiring the most transfusions. These data will be helpful to counsel mothers in preterm labor regarding the need of transfusions for each birth weight category. Red cell transfusion practice has not changed over this 6-year period in the 1990s. Additional measures such as erythropoietin or even stricter transfusion criteria may be necessary to decrease transfusions further. However, safety of such measures should be carefully evaluated.
Asunto(s)
Transfusión de Eritrocitos/estadística & datos numéricos , Recién Nacido de muy Bajo Peso , Humanos , Recién Nacido , Estudios RetrospectivosRESUMEN
Variables influencing maternal responsiveness of primiparous mothers in the postpartum period were explored. Forty mothers, aged 17 to 24, were randomly assigned to either a control group, or to a group with one of two experimental conditions: additional information given mothers about the sensory capacity of neonates, or additional postpartum contact with their infants. Age differences in maternal responsiveness were also examined. Fourteen dependent measures of maternal behavior were obtained from video-taped sessions of mothers watching their infants. In addition, lateral preference of mothers for their infant following midline presentation was also noted. At the time of hospital discharge (a mean time of 3.5 days following birth) no differences were found on the dependent measures for either experimental condition. The age of the mother was isolated as a variable influencing maternal readiness. Mothers were divided into three age groups: low (17 and 18 years, N = 17), middle (19 and 20 years, N = 10), and high (21 to 23 years, N = 13). Age effects upon the 15 measures were assessed. The results suggest that there is a "critical" age when a mother may develop maternal readiness. Mothers 19 years of age and older demonstrated significantly more maternal responsiveness toward their infants than did mothers 18 years and younger.
Asunto(s)
Conducta Materna , Periodo Posparto , Factores de Edad , Femenino , Humanos , Relaciones Madre-Hijo , EmbarazoRESUMEN
Muscle cells in cultures established from biopsy specimens of two children with an infantile-fatal form of X-linked recessive muscle fiber smallness with central nuclei showed an unusual ability to proliferate through numerous passages. Ultrastructurally, the cultured muscle fibers appeared very immature even after several weeks. The nuclei were large, the number of ribosomes was greatly increased, the myofibrils remained unstriated, and glycogen was accumulated in large lakes. The plasmalemma bound concanavalin A, alpha-bungarotoxin, and ruthenium red normally, but with tannic acid it did not show the dark binding of mature fibers. Biochemically, in the cultured muscle fibers, beta-adrenergic receptors were quantitatively normal. The level of adenylate cyclase in membranes was less than in cultured normal muscle; this defect could be responsible for impaired control mechanisms resulting in the other abnormalities observed.