The effect of sucrose on infants during a painful procedure

PurposeThe purpose of this study was to test the efficacy of treating the pain among newborn infants associated with a medical procedure with sucrose with regard to overall physiological and behavioral stability.Methods103 newborn infants were enrolled in this study. The control group (n=63) did not receive any treatment. The experimental group (n=40) received 2 mL of 24% sucrose solution two minutes before a routine heel stick. The pain was assessed by measurements of physiological changes [e.g. pulse rate, oxygen saturation, salivary cortisol (hydrocortisone)] and behavioral changes [e.g. crying time, and the neonatal infant pain scale (NIPS) for neonates].ResultsThere were no differences among the groups with respect to physiological changes associated with the pain from the procedure. However, there were significant group differences in behavioral changes to the pain. In the control group, the median crying time was 13 seconds, while in the experimental group, the median crying time was 3.5 seconds (P=.000). In the control group the median NIPS score was 4, while in the experimental group the median NIPS score was 2 (P=.000).ConclusionsThese findings suggest that sucrose can be an effective method for the management of stress responses in infants with regard to behavior. However, this treatment had no significant physiological effects

Emergence and Wide Dissemination of CTX-M-type ESBLs, and CMY-2- and DHA-1-type AmpC β-Lactamases in Korean Respiratory Isolates of Klebsiella pneumoniae

Respiratory isolates of Klebsiella pneumoniae in Korea during 2002-2003 were studied to determine the prevalence and types of extended-spectrum β-lactamases (ESBLs) and plasmid-mediated AmpC β-lactamases (PABLs). ESBL-production was tested by double-disk synergy, and genotypes of β-lactamases were determined by PCR and sequencing. ESBLs were detected in 28.4% of 373 isolates, and the most prevalent types were SHV-12 (63 isolates) and CTX-M-14 (9 isolates). Forty of 75 ESBL-producers (53.5%) also had PABLs: 21 isolates with CMY-2-like, 17 with DHA-1-like. Pulsed-field gel electrophoresis showed 19 types and 25 of 74 isolates had an identical pattern, indicating nosocomial spread. Dissemination of ESBL- and PABL-producing K. pneumoniae strains in Korea is a particular concern, as it limits the choice of antimicrobial agents for treatment of infections

Pregnancy loss in dairy cows: the contributing factors, the effects on reproductive performance and the economic impact

This study investigated the effects of the herd, cow parity, the insemination protocol and season on the incidence of pregnancy loss (PL) in dairy herds. Furthermore, we determined the downstream effects of PL on reproductive performance and its economic impact. The overall incidence rate of PL was 6.9% in 1,001 pregnant cows and its incidence peaked (p < 0.01) during the second trimester of gestation. GLIMMIX analysis revealed that cow parity was the important risk factor for the PL. The odds ratio showed that the likelihood of PL in cows with parities of 1 or 2 was decreased by 0.6 or 0.5 fold compared to the cows with a parity of 3 or higher. Following PL, the mean rate of endometritis was 23.2% and endometritis was more common (p < 0.05) when PL occurred during the third trimester than during the first and second trimesters. The mean culling rate was 46.4% and this did not differ with the period of PL. The overall mean intervals from PL to the first service and conception were 63.4 and 101.8 days, respectively. The mean interval from PL to first service was longer (p < 0.01) for cows with PL during the third trimester than for the cows with PL during the first and second trimesters. The economic loss resulting from each PL was estimated at approximately $2,333, and this was largely due to an extended calving interval and increased culling. These results suggest that cow parity affects the incidence of PL, which extends calving interval and causes severe economic loss of dairy herds

Classification of Metastatic versus Non-Metastatic Axillary Nodes in Breast Cancer Patients: Value of Cortex-Hilum Area Ratio with Ultrasound

Purpose: To investigate the significance of the cortex-hilum (CH) area ratio and longitudinal-transverse (LT) axis ratio and the blood flow pattern for diagnosis of metastatic axillary lymph nodes by ultrasound in breast cancer patients. Methods: From October 2005 to July 2006, we prospectively evaluated axillary nodes with ultrasound in 205 consecutive patients who had category 4B, 4C or 5 breast lesions according to the Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-Ultrasound ®). Among the 205, there were 24 patients who had pathologic verification of breast cancer and axillary lymph node status. For a total of 80 axillary nodes we measured the areas of the cortex and hilum of lymph nodes and calculated the area ratio. We also measured the length of the longitudinal and transverse axis of the lymph nodes and calculated the length ratio. We evaluated the blood flow pattern on power Doppler imaging and classified each lymp

Development of Prenatal Event History Calendar for Black Women

Objectives : To identify psychosocial factors that Black women think should be addressed in prenatal care assessment and develop a Prenatal Event History Calendar to assess these factors. Design : A qualitative descriptive study. Setting : Two inner city hospital prenatal care clinics in Southeastern Michigan. Participants : Twenty-two Black women who had attended at least 2 prenatal care visits. Method : Three focus groups were conducted using a semistructured interview guide. Main Outcome Measure : Using the constant comparative method of analysis ( Glaser, 1978, 1992 ) themes were identified that were relevant to Black women during prenatal care visits. Results : The women in this study wanted to talk with their providers about psychosocial factors and not just the physical aspects of pregnancy. To “go off the pregnancy” represents pregnant women's desire to discuss psychosocial factors that were important to them during prenatal care. Five themes emerged from the data and were used to develop categories for the Prenatal Event History Calendar: relationships, stress, routines, health history perceptions, and beliefs. Conclusion : One vital component of prenatal care assessment is assessing for psychosocial risk factors. Prenatal Event History Calendar was specifically developed to provide a comprehensive and contextually linked psychosocial risk assessment for use with pregnant Black women.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73627/1/j.1552-6909.2008.00255.x.pd

Predictors of Pulmonary Function Response to Treatment with Salmeterol/fluticasone in Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease and responses to therapies are highly variable. The aim of this study was to identify the predictors of pulmonary function response to 3 months of treatment with salmeterol/fluticasone in patients with COPD. A total of 127 patients with stable COPD from the Korean Obstructive Lung Disease (KOLD) Cohort, which were prospectively recruited from June 2005 to September 2009, were analyzed retrospectively. The prediction models for the FEV1, FVC and IC/TLC changes after 3 months of treatment with salmeterol/fluticasone were constructed by using multiple, stepwise, linear regression analysis. The prediction model for the FEV1 change after 3 months of treatment included wheezing history, pre-bronchodilator FEV1, post-bronchodilator FEV1 change and emphysema extent on CT (R = 0.578). The prediction models for the FVC change after 3 months of treatment included pre-bronchodilator FVC, post-bronchodilator FVC change (R = 0.533), and those of IC/ TLC change after 3 months of treatment did pre-bronchodilator IC/TLC and post-bronchodilator FEV1 change (R = 0.401). Wheezing history, pre-bronchodilator pulmonary function, bronchodilator responsiveness, and emphysema extent may be used for predicting the pulmonary function response to 3 months of treatment with salmeterol/fluticasone in patients with COPD